MEDICARE: OHANA ACUPUNCTURE 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	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1306628573
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OHANA ACUPUNCTURE CLINIC, LLC

Provider Business Mailing Address
First Line	:	700 RICHARDS ST APT 2401
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96813-4621
Country	:	US
Telephone Number	:	808-772-1143
Fax Number	:

Provider Business Practice Location Address
First Line	:	1188 BISHOP ST STE 2308
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96813-3309
Country	:	US
Telephone Number	:	808-772-1143
Fax Number	:

Authorized Official
Title or Position	:	ACUPUNCTUIRST
Name	:	SOOK KIM
Credential	:
Telephone Number	:	808-772-1143

Provider Enumeration Date	:	10/20/2023
Last Update Date	:	10/20/2023

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