Provider Demographics
NPI:1346494499
Name:MICHAEL J. MASTERS, D.C., INC.
Entity Type:Organization
Organization Name:MICHAEL J. MASTERS, D.C., INC.
Other - Org Name:MASTERS BACK & NECK PAIN RELIEF CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MASTERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:808-591-0099
Mailing Address - Street 1:1010 S KING ST
Mailing Address - Street 2:SUITE 213
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1701
Mailing Address - Country:US
Mailing Address - Phone:808-591-0099
Mailing Address - Fax:808-593-0994
Practice Address - Street 1:1010 S KING ST
Practice Address - Street 2:SUITE 213
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1701
Practice Address - Country:US
Practice Address - Phone:808-591-0099
Practice Address - Fax:808-593-0994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-14
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDC355111N00000X
HIDC1176111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIT01036Medicare UPIN
HIBJ209Medicare PIN