Provider Demographics
NPI:1114946407
Name:HOZAKI, BRIAN (RPT)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:HOZAKI
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2180 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-1666
Mailing Address - Country:US
Mailing Address - Phone:808-242-6464
Mailing Address - Fax:808-984-7432
Practice Address - Street 1:2180 MAIN ST
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1666
Practice Address - Country:US
Practice Address - Phone:808-242-6464
Practice Address - Fax:808-984-7432
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT896225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI063453OtherHMSA- 65CP - HMSA QUEST
HI977443OtherUHA
HI99017685996793B072OtherTRICARE - CHAMPUS
HIS84239Medicare UPIN
HI063453OtherHMSA- 65CP - HMSA QUEST