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NPI Code Detail

MEDICARE: MR. GEORGE HENRY ALBA RN

MEDICARE: MR. GEORGE HENRY ALBA RN
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
1163W00000XRegistered NurseRN58044HI

General Provider Information

NPI Number : 1366073512
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GEORGE HENRY ALBA RN
Provider Business Mailing Address
First Line : 1128 ALA NAPUNANI ST APT 506
Second Line :
City : HONOLULU
State : HI
Zip : 96818-1605
Country : US
Telephone Number :
Fax Number : 808-382-5970
Provider Business Practice Location Address
First Line : 480 CENTRAL AVE
Second Line :
City : JBPHH
State : HI
Zip : 96860-4908
Country : US
Telephone Number : 808-473-1880
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2020
Last Update Date : 01/27/2020

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