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General NPI Number Information
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NPI Number | 1720768278
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Entity Type | Organization
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Legal Business Name | JOY PAHANG, LLC
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Dates
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Enumeration Date | 07/20/2023
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Last Update Date | 07/20/2023
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Provider Practice Location Address
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Address Line | 91-1488 PUKANALA ST
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City | EWA BEACH
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State | HI
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Zip | 96706-4678
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Country | US
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Telephone | 808-308-5465
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 970116
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City | WAIPAHU
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State | HI
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Zip | 96797-0116
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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 | CO-OWNER
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Name | MARK PAHANG
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Credential | DPT
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Telephone | 808-308-5465
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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