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General NPI Number Information
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NPI Number | 1447486493
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Entity Type | Organization
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Legal Business Name | PEARL HARBOR CARE INC
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Dates
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Enumeration Date | 06/04/2009
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Last Update Date | 06/04/2009
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Provider Practice Location Address
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Address Line | 75-167 HUALALAI RD STE 102
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City | KAILUA KONA
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State | HI
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Zip | 96740-1714
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Country | US
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Telephone | 808-430-1186
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Fax |
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Provider Business Mailing Address
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Address Line | 1146 N CENTRAL AVE #354
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City | GLENDALE
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State | CA
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Zip | 91202-2506
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Country | US
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Telephone | 808-430-1186
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | FRANK A WILLIAMS
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Credential | MD
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Telephone | 808-430-1186
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 6998
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License Number State | HI
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