Provider Demographics
NPI:1366469082
Name:HOZAKI PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:HOZAKI PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:HARUO
Authorized Official - Last Name:HOZAKI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:808-281-0618
Mailing Address - Street 1:1721 WILI PA LOOP STE 102 B
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-1278
Mailing Address - Country:US
Mailing Address - Phone:808-249-8384
Mailing Address - Fax:
Practice Address - Street 1:1721 WILI PA LOOP STE 102 B
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1278
Practice Address - Country:US
Practice Address - Phone:808-249-8384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI896225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI055076-02Medicaid
HIB6345-9OtherHMSA
HIB6345-9OtherHMSA 65C PLUS
HI055076-02Medicaid
HI=========OtherHMA, INC.
HIB6345-9OtherHMSA 65C PLUS