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General NPI Number Information
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NPI Number | 1932590536
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Entity Type | Individual
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Provider Name | ADDISON BULOSAN D.C.
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Gender | Male
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Dates
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Enumeration Date | 02/18/2015
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Last Update Date | 02/18/2015
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Provider Practice Location Address
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Address Line | 2959 UMI ST SUITE 202
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City | LIHUE
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State | HI
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Zip | 96766-1806
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Country | US
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Telephone | 808-369-9733
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Fax | 808-369-9733
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Provider Business Mailing Address
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Address Line | 2959 UMI ST SUITE 202
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City | LIHUE
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State | HI
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Zip | 96766-1806
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Country | US
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Telephone | 808-369-9733
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Fax | 808-369-9733
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NT0100X
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Taxonomy Name | Thermography Chiropractor
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License Number | DC1275
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 111NT0100X
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Taxonomy Name | Thermography Chiropractor
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License Number | 32701
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License Number State | CA
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