Provider Demographics
NPI:1417330846
Name:HOOLA MALAMALAMA
Entity Type:Organization
Organization Name:HOOLA MALAMALAMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:TRUDELL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:808-683-9770
Mailing Address - Street 1:PO BOX 235-107
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96823
Mailing Address - Country:US
Mailing Address - Phone:808-683-9770
Mailing Address - Fax:808-212-9459
Practice Address - Street 1:44-116 KEAALAU PLACE
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744
Practice Address - Country:US
Practice Address - Phone:808-683-9770
Practice Address - Fax:808-212-9459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-02
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty