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General NPI Number Information
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NPI Number | 1295916112
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Entity Type | Organization
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Legal Business Name | JACK JIE ZHOU MD INC.
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Dates
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Enumeration Date | 11/20/2007
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Last Update Date | 06/23/2017
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Provider Practice Location Address
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Address Line | 100 N BERETANIA ST STE 104
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City | HONOLULU
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State | HI
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Zip | 96817-4768
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Country | US
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Telephone | 808-538-6532
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Fax |
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Provider Business Mailing Address
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Address Line | 100 N BERETANIA ST STE 104
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City | HONOLULU
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State | HI
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Zip | 96817-4768
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Country | US
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Telephone | 808-538-6532
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JACK ZHOU
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Credential | MD
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Telephone | 808-538-6532
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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 | 9020
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 9020
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License Number State | HI
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