MEDICARE: ALOHA PAIN CLINIC, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP3300X	Pain Clinic/Center

General Provider Information

NPI Number	:	1174756662
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALOHA PAIN CLINIC, LLC

Provider Business Mailing Address
First Line	:	PO BOX 7127
Second Line	:
City	:	KAMUELA
State	:	HI
Zip	:	96743-7127
Country	:	US
Telephone Number	:	808-885-7246
Fax Number	:

Provider Business Practice Location Address
First Line	:	68-1845 WAIKOLOA RD STE 216
Second Line	:
City	:	WAIKOLOA
State	:	HI
Zip	:	96738-5584
Country	:	US
Telephone Number	:	808-885-7246
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LYNN PUANA
Credential	:	MD
Telephone Number	:	808-315-1922

Provider Enumeration Date	:	08/31/2009
Last Update Date	:	02/23/2011

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