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General NPI Number Information
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NPI Number | 1255683785
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Entity Type | Organization
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Legal Business Name | BIG ISLAND PAIN CENTER INC.
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Dates
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Enumeration Date | 10/08/2012
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 32 ULULANI ST
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City | HILO
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State | HI
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Zip | 96720-2933
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Country | US
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Telephone | 808-934-9675
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Fax |
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Provider Business Mailing Address
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Address Line | 8 CHERRY HILLS DR
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City | ENGLEWOOD
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State | CO
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Zip | 80113-4812
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Country | US
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Telephone | 808-934-9675
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE OFFICER
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Name | DR. LYNN PUANA
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Credential | MD
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Telephone | 808-934-9675
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | W5908947001
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number | W5908947001
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License Number State | HI
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Taxonomy #4
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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