MEDICARE: OHANA GENETICS 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	261QG0250X	Genetics Clinic/Center

General Provider Information

NPI Number	:	1659680684
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OHANA GENETICS INC

Provider Business Mailing Address
First Line	:	350 HEMA PL
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96821-1835
Country	:	US
Telephone Number	:	808-265-1082
Fax Number	:	808-377-5949

Provider Business Practice Location Address
First Line	:	350 HEMA PL
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96821-1835
Country	:	US
Telephone Number	:	808-265-1082
Fax Number	:	808-377-5949

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SUSAN DONLON
Credential	:	MS
Telephone Number	:	808-265-1082

Provider Enumeration Date	:	09/24/2010
Last Update Date	:	09/24/2010

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Directions to “OHANA GENETICS INC ” Practice Location

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