Provider Demographics
NPI:1982024923
Name:OAC CLINICS HAWAII LLC
Entity Type:Organization
Organization Name:OAC CLINICS HAWAII LLC
Other - Org Name:HANA PONO CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SPENCER
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-713-1696
Mailing Address - Street 1:1401 S BERETANIA STREET
Mailing Address - Street 2:SUITE 450
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1871
Mailing Address - Country:US
Mailing Address - Phone:808-537-6688
Mailing Address - Fax:808-537-6689
Practice Address - Street 1:1585 KAPIOLANI BLVD
Practice Address - Street 2:SUITE 1800
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4500
Practice Address - Country:US
Practice Address - Phone:808-941-3363
Practice Address - Fax:808-949-0483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-17
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty