Provider Demographics
NPI:1083773543
Name:UNKRUR, PAUL (PHD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:UNKRUR
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 S KING ST STE 908
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1953
Mailing Address - Country:US
Mailing Address - Phone:808-597-1999
Mailing Address - Fax:808-597-1201
Practice Address - Street 1:1150 S KING ST STE 908
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1953
Practice Address - Country:US
Practice Address - Phone:808-597-1999
Practice Address - Fax:808-597-1201
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY 633103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIPSY633OtherMDX HAWAII
HI022380-0OtherHMSA - BLUE CROSS BLUE SH
HI249721-01Medicaid
HI249721-01Medicaid