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General NPI Number Information
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NPI Number | 1457673675
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Entity Type | Organization
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Legal Business Name | HEALTHY PREFERRED INC
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Dates
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Enumeration Date | 02/16/2010
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Last Update Date | 02/16/2010
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Provider Practice Location Address
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Address Line | 74-5620 PALANI RD STE 212
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City | KAILUA KONA
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State | HI
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Zip | 96740-3640
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Country | US
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Telephone | 888-406-8555
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Fax |
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Provider Business Mailing Address
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Address Line | 1250 S GLENDALE AVE SUITE B, PMB 101
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City | GLENDALE
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State | CA
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Zip | 91205-5642
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Country | US
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Telephone | 888-406-8555
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | OAKLEY M DAVIS
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Credential | M.D.
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Telephone | 888-406-8555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD12522
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License Number State | HI
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