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General NPI Number Information
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NPI Number | 1720605249
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Entity Type | Organization
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Legal Business Name | ALOHA PSYCHIATRY
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Dates
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Enumeration Date | 06/30/2020
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Last Update Date | 06/30/2020
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Provider Practice Location Address
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Address Line | 78 HOLMES PL
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City | TUSTIN
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State | CA
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Zip | 92782-3738
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Country | US
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Telephone | 808-304-0406
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Fax |
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Provider Business Mailing Address
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Address Line | 1968 S COAST HWY # 2093
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-3681
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. JONATHAN ALABANZA SY
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Credential | MD
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Telephone | 808-304-0406
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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