Provider Demographics
NPI:1528574100
Name:INSIGHT EEG LLC
Entity Type:Organization
Organization Name:INSIGHT EEG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:HANNUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-277-6816
Mailing Address - Street 1:PO BOX 31000 MAIL CODE 5765
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96849-0001
Mailing Address - Country:US
Mailing Address - Phone:808-593-9944
Mailing Address - Fax:808-593-9955
Practice Address - Street 1:1010 S KING ST STE 218A
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1703
Practice Address - Country:US
Practice Address - Phone:808-593-9944
Practice Address - Fax:808-593-9955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-19
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory