MEDICARE: MR. ALIFELETI MALUPO MED

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1750501177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALIFELETI MALUPO MED

Provider Business Mailing Address
First Line	:	91-741 IHIPEHU ST
Second Line	:
City	:	EWA BEACH
State	:	HI
Zip	:	96706-2405
Country	:	US
Telephone Number	:	808-689-5162
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 S BERETANIA ST
Second Line	:	SUITE 402
City	:	HONOLULU
State	:	HI
Zip	:	96826-1932
Country	:	US
Telephone Number	:	808-945-3690
Fax Number	:	808-945-2811

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	07/08/2007

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