Provider Demographics
NPI:1679590517
Name:CKW STAR INC.
Entity Type:Organization
Organization Name:CKW STAR INC.
Other - Org Name:STAR PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CURT
Authorized Official - Middle Name:K
Authorized Official - Last Name:WATANABE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:808-454-2285
Mailing Address - Street 1:850 KAMEHAMEHA HWY
Mailing Address - Street 2:SUITE 167C
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-2656
Mailing Address - Country:US
Mailing Address - Phone:808-454-2285
Mailing Address - Fax:808-454-1334
Practice Address - Street 1:850 KAMEHAMEHA HWY
Practice Address - Street 2:SUITE 167C
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-2656
Practice Address - Country:US
Practice Address - Phone:808-454-2285
Practice Address - Fax:808-454-1334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT972225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH54843Medicare ID - Type UnspecifiedCURT K. WATANABE, MPT
HIH56124Medicare ID - Type UnspecifiedKARA JO NISHIKAWA, MSPT
HIP02917Medicare UPIN