Provider Demographics
NPI:1942548268
Name:EHUKAI KAPOLEI, LLC
Entity Type:Organization
Organization Name:EHUKAI KAPOLEI, LLC
Other - Org Name:OAHU SPINE AND REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-488-5555
Mailing Address - Street 1:970 N KALAHEO AVE
Mailing Address - Street 2:SUITE C-316
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-1866
Mailing Address - Country:US
Mailing Address - Phone:808-488-5555
Mailing Address - Fax:808-312-6363
Practice Address - Street 1:970 N KALAHEO AVE
Practice Address - Street 2:SUITE C-316
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-1866
Practice Address - Country:US
Practice Address - Phone:808-488-5555
Practice Address - Fax:808-312-6363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-21
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty