Provider Demographics
NPI:1881203289
Name:HAWAII INJURY RECOVERY CENTER, INC
Entity Type:Organization
Organization Name:HAWAII INJURY RECOVERY CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:MORIOKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-343-3915
Mailing Address - Street 1:321 N KUAKINI ST STE 501
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2387
Mailing Address - Country:US
Mailing Address - Phone:808-343-3915
Mailing Address - Fax:808-762-0775
Practice Address - Street 1:321 N KUAKINI ST STE 501
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2387
Practice Address - Country:US
Practice Address - Phone:808-762-0777
Practice Address - Fax:808-762-0775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-31
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI598386Medicaid