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NPI 1295613230

NPI 1295613230 : EDISON PUMARAS ERORITA LMT : HONOLULU, HI

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General NPI Number Information
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    NPI Number           |    1295613230
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    Entity Type          |    Individual 
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    Provider Name        |    EDISON PUMARAS ERORITA LMT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/26/2025
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    Last Update Date     |    08/26/2025
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Provider Practice Location Address
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    Address Line         |    1010 S KING ST STE 217 
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    City                 |    HONOLULU
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    State                |    HI
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    Zip                  |    96814-1703
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    Country              |    US
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    Telephone            |    808-593-7717
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    355 AOLOA ST APT E201 
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    City                 |    KAILUA
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    State                |    HI
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    Zip                  |    96734-3043
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    Country              |    US
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    Telephone            |    808-445-5741
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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        |    225700000X
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    Taxonomy Name        |    Massage Therapist
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    License Number       |    MAT-17342
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    License Number State |    HI
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