Provider Demographics
NPI:1114105566
Name:REINA M.A. HARRIS, M.D., LLC
Entity Type:Organization
Organization Name:REINA M.A. HARRIS, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:REINA
Authorized Official - Middle Name:MA
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-544-0044
Mailing Address - Street 1:550 S BERETANIA ST
Mailing Address - Street 2:SUITE 614
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2414
Mailing Address - Country:US
Mailing Address - Phone:808-544-0044
Mailing Address - Fax:808-546-1177
Practice Address - Street 1:550 S BERETANIA ST
Practice Address - Street 2:SUITE 614
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2414
Practice Address - Country:US
Practice Address - Phone:808-544-0044
Practice Address - Fax:808-546-1177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI14145207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty