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General NPI Number Information
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NPI Number | 1265227656
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Entity Type | Organization
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Legal Business Name | LA HEALTH CLINIC LLC
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Dates
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Enumeration Date | 04/14/2025
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 510 KUNEHI ST APT 103
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City | KAPOLEI
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State | HI
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Zip | 96707-2068
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Country | US
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Telephone | 808-751-1358
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Fax |
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Provider Business Mailing Address
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Address Line | 510 KUNEHI ST APT 103
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City | KAPOLEI
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State | HI
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Zip | 96707-2068
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Country | US
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Telephone | 808-751-1358
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PATTSY ROSAS
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Credential | FNP
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Telephone | 956-410-9028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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