Provider Demographics
NPI:1497476188
Name:HAWAII PODIATRY LLC.
Entity Type:Organization
Organization Name:HAWAII PODIATRY LLC.
Other - Org Name:OHANA FOOT & ANKLE SPECIALIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEANE
Authorized Official - Middle Name:J
Authorized Official - Last Name:WATANABE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:808-726-2161
Mailing Address - Street 1:1245 KUALA ST STE 102A
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-3900
Mailing Address - Country:US
Mailing Address - Phone:808-726-2161
Mailing Address - Fax:808-726-2163
Practice Address - Street 1:1245 KUALA ST STE 102A
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-3900
Practice Address - Country:US
Practice Address - Phone:808-726-2161
Practice Address - Fax:808-726-2163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-09
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIPO-196OtherMD LICENSE