Provider Demographics
NPI:1437357985
Name:CENTRAL OAHU PHYSICAL THERAPY SPECIALISTS
Entity Type:Organization
Organization Name:CENTRAL OAHU PHYSICAL THERAPY SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:TAGAWA
Authorized Official - Suffix:
Authorized Official - Credentials:MS PT , CSCS
Authorized Official - Phone:808-621-6400
Mailing Address - Street 1:PO BOX 1742
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701
Mailing Address - Country:US
Mailing Address - Phone:808-621-6400
Mailing Address - Fax:
Practice Address - Street 1:916 KILANI AVE # A
Practice Address - Street 2:
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786-2102
Practice Address - Country:US
Practice Address - Phone:808-621-6400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-06
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH101894Medicare PIN