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General NPI Number Information
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NPI Number | 1952567380
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Entity Type | Organization
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Legal Business Name | WAIKIKI HEALTH
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Dates
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Enumeration Date | 08/05/2008
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Last Update Date | 12/06/2013
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Provider Practice Location Address
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Address Line | 3020 WAIALAE AVE
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City | HONOLULU
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State | HI
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Zip | 96816-1506
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Country | US
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Telephone | 808-922-4790
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Fax | 808-922-4780
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Provider Business Mailing Address
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Address Line | 277 OHUA AVE
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City | HONOLULU
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State | HI
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Zip | 96815-6612
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Country | US
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Telephone | 808-922-4787
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Fax | 808-922-6454
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | SHEILA BECKHAM
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Credential | RD, MPH
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Telephone | 808-791-9302
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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