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General NPI Number Information
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NPI Number | 1285938191
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Entity Type | Organization
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Legal Business Name | HAWAII INSTITUTE FOR INTEGRATIVE MEDICINE
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Dates
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Enumeration Date | 01/06/2011
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Last Update Date | 01/06/2011
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Provider Practice Location Address
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Address Line | 1441 KAPIOLANI BLVD SUITE 1419
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City | HONOLULU
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State | HI
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Zip | 96814-4402
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Country | US
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Telephone | 877-341-8161
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Fax |
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Provider Business Mailing Address
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Address Line | 1441 KAPIOLANI BLVD SUITE 1419
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City | HONOLULU
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State | HI
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Zip | 96814-4402
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Country | US
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Telephone | 877-341-8161
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. JEFFREY R MAEHARA
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Credential | MD
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Telephone | 877-341-8161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD-11924
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License Number State | HI
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