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General NPI Number Information
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NPI Number | 1811788961
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Entity Type | Organization
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Legal Business Name | MANOA FAMILY PRACTICE LLC
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Dates
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Enumeration Date | 05/16/2025
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 2756 WOODLAWN DR STE 6-202
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City | HONOLULU
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State | HI
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Zip | 96822-1856
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Country | US
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Telephone | 808-988-8880
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Fax |
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Provider Business Mailing Address
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Address Line | 4348 WAIALAE AVE STE 769
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City | HONOLULU
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State | HI
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Zip | 96816-5767
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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 | EXECUTIVE DIRECTOR
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Name | ALICIA KNOWLES
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Credential | NP
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Telephone | 808-492-6751
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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