Provider Demographics
NPI:1164822177
Name:CENTRAL OAHU PHYSICAL THERAPY SPECIALISTS, LLC
Entity Type:Organization
Organization Name:CENTRAL OAHU PHYSICAL THERAPY SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BERNARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:SORIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-450-9250
Mailing Address - Street 1:PO BOX 1742
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-7742
Mailing Address - Country:US
Mailing Address - Phone:808-621-6400
Mailing Address - Fax:
Practice Address - Street 1:98-211 PALI MOMI ST
Practice Address - Street 2:402
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4301
Practice Address - Country:US
Practice Address - Phone:808-450-9250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-27
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3864225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty