Provider Demographics
NPI:1790707727
Name:FOOT & ANKLE INSTITUTE OF HAWAII
Entity Type:Organization
Organization Name:FOOT & ANKLE INSTITUTE OF HAWAII
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ATTILIO
Authorized Official - Middle Name:
Authorized Official - Last Name:AVINO
Authorized Official - Suffix:JR
Authorized Official - Credentials:DPM
Authorized Official - Phone:808-487-6903
Mailing Address - Street 1:99-128 AIEA HEIGHTS DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-3932
Mailing Address - Country:US
Mailing Address - Phone:808-487-6903
Mailing Address - Fax:808-487-6906
Practice Address - Street 1:99-128 AIEA HEIGHTS DR
Practice Address - Street 2:SUITE 205
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-3932
Practice Address - Country:US
Practice Address - Phone:808-487-6903
Practice Address - Fax:808-487-6906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI5416020001Medicare NSC
HIH100282Medicare PIN