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General NPI Number Information
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NPI Number | 1275603813
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Entity Type | Individual
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Provider Name | PAUL KIMO PESTANA DC
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Gender | Male
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 10/02/2007
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Provider Practice Location Address
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Address Line | 277 OHUA AVE # 101H
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City | HONOLULU
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State | HI
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Zip | 96815-3643
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Country | US
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Telephone | 808-738-8825
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 161132
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City | HONOLULU
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State | HI
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Zip | 96816-0924
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Country | US
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Telephone | 808-738-8825
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 347
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License Number State | HI
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