Provider Demographics
NPI:1043442908
Name:HAWAII PACIFIC NEUROSCIENCE LLC
Entity Type:Organization
Organization Name:HAWAII PACIFIC NEUROSCIENCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KORE
Authorized Official - Middle Name:K
Authorized Official - Last Name:LIOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-261-4476
Mailing Address - Street 1:2230 LILIHA ST STE 104
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-7357
Mailing Address - Country:US
Mailing Address - Phone:808-261-4476
Mailing Address - Fax:808-263-4476
Practice Address - Street 1:2230 LILIHA ST STE 104
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-7357
Practice Address - Country:US
Practice Address - Phone:808-261-4476
Practice Address - Fax:808-263-4476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-11
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD121492084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00A0288512OtherHMSA
HI637233Medicaid