Provider Demographics
NPI:1467878017
Name:FAST WALK-IN MEDICAL CLINIC LLC
Entity Type:Organization
Organization Name:FAST WALK-IN MEDICAL CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN/DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:YUN
Authorized Official - Middle Name:SUK
Authorized Official - Last Name:HONG
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:808-722-0233
Mailing Address - Street 1:1600 KAPIOLANI BLVD STE 601
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-3897
Mailing Address - Country:US
Mailing Address - Phone:808-947-7582
Mailing Address - Fax:808-947-7583
Practice Address - Street 1:1600 KAPIOLANI BLVD STE 601
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3897
Practice Address - Country:US
Practice Address - Phone:808-947-7582
Practice Address - Fax:808-947-7583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-06
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN1695261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care