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General NPI Number Information
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NPI Number | 1710388624
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Entity Type | Organization
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Legal Business Name | LULUMAFUIE FIATOA, M.D. LLC
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Dates
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Enumeration Date | 09/10/2014
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Last Update Date | 09/10/2014
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Provider Practice Location Address
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Address Line | 94-307 FARRINGTON HWY B-01
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City | WAIPAHU
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State | HI
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Zip | 96797-2565
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Country | US
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Telephone | 808-847-0487
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 17793
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City | HONOLULU
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State | HI
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Zip | 96817-0793
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Country | US
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Telephone | 808-779-1169
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LULUMAFUIE FIATOA
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Credential | MD
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Telephone | 808-779-1169
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD5016
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License Number State | HI
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