MEDICARE: EAST OAHU MEDICAL CENTER INC

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	207R00000X	Internal Medicine Physician
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1215090139
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAST OAHU MEDICAL CENTER INC

Provider Business Mailing Address
First Line	:	850 W HIND DR
Second Line	:	SUITE #110
City	:	HONOLULU
State	:	HI
Zip	:	96821-1855
Country	:	US
Telephone Number	:	808-373-5728
Fax Number	:	808-377-3432

Provider Business Practice Location Address
First Line	:	850 WEST HIND DR
Second Line	:	SUITE 110
City	:	HONOLULU
State	:	HI
Zip	:	96821-1845
Country	:	US
Telephone Number	:	808-373-5728
Fax Number	:	808-377-3432

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. KRISTY S HANZAWA
Credential	:
Telephone Number	:	808-373-5728

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	11/21/2011

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