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General NPI Number Information
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NPI Number | 1811369408
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Entity Type | Organization
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Legal Business Name | THE QUEEN'S MEDICAL CENTER
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Dates
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Enumeration Date | 10/22/2015
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Last Update Date | 10/22/2015
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Provider Practice Location Address
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Address Line | 1301 PUNCHBOWL ST
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City | HONOLULU
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State | HI
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Zip | 96813
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Country | US
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Telephone | 808-538-9011
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Fax |
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Provider Business Mailing Address
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Address Line | 155 N BERETANIA ST APT 1505
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City | HONOLULU
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State | HI
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Zip | 96817
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Country | US
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Telephone | 808-321-8721
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIETITIAN
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Name | MR. FONG CHUN KWOK
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Credential | R.D.
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Telephone | 808-321-8721
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 86034562
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License Number State | HI
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