Provider Demographics
NPI:1518098649
Name:MILILANI BACK CARE CENTER, INC.
Entity Type:Organization
Organization Name:MILILANI BACK CARE CENTER, INC.
Other - Org Name:DOWNTOWN CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TED
Authorized Official - Middle Name:WAI HOU
Authorized Official - Last Name:CHUN
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DABCO
Authorized Official - Phone:808-625-0098
Mailing Address - Street 1:95-720 LANIKUHANA AVE
Mailing Address - Street 2:240
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-2985
Mailing Address - Country:US
Mailing Address - Phone:808-625-0098
Mailing Address - Fax:
Practice Address - Street 1:95-720 LANIKUHANA AVE
Practice Address - Street 2:240
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-2985
Practice Address - Country:US
Practice Address - Phone:808-625-0098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI456111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH0000QCCHGMedicare ID - Type Unspecified