Provider Demographics
NPI:1407380595
Name:LOTUS ENTERPRISES
Entity Type:Organization
Organization Name:LOTUS ENTERPRISES
Other - Org Name:LOTUS ACUPUNCTURE & ORIENTAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:OLIVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:808-633-6545
Mailing Address - Street 1:PO BOX 1065
Mailing Address - Street 2:
Mailing Address - City:HAIKU
Mailing Address - State:HI
Mailing Address - Zip Code:96708-1065
Mailing Address - Country:US
Mailing Address - Phone:808-633-6545
Mailing Address - Fax:
Practice Address - Street 1:1043 MAKAWAO AVE
Practice Address - Street 2:
Practice Address - City:MAKAWAO
Practice Address - State:HI
Practice Address - Zip Code:96768-9465
Practice Address - Country:US
Practice Address - Phone:808-633-6545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-14
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI846171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty