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General NPI Number Information
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NPI Number | 1942638689
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Entity Type | Organization
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Legal Business Name | HONOLULU PSYCHIATRIC SERCIES LLC
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Dates
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Enumeration Date | 10/16/2013
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Last Update Date | 10/16/2013
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Provider Practice Location Address
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Address Line | 1188 BISHOP ST STE 1102
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City | HONOLULU
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State | HI
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Zip | 96813-3304
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Country | US
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Telephone | 808-388-4969
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Fax |
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Provider Business Mailing Address
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Address Line | 1188 BISHOP ST STE 1102
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City | HONOLULU
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State | HI
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Zip | 96813-3304
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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 | OWNER
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Name | DR. RAYMOND DAVIDSON
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Credential | MD
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Telephone | 808-388-4969
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number | 15998
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 15998
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License Number State | HI
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