Provider Demographics
NPI:1992030852
Name:HAWAIIAN ACTION REHAB, INC
Entity Type:Organization
Organization Name:HAWAIIAN ACTION REHAB, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:TOMIKO
Authorized Official - Middle Name:O
Authorized Official - Last Name:RICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-953-2121
Mailing Address - Street 1:1149 BETHEL ST
Mailing Address - Street 2:#509
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2236
Mailing Address - Country:US
Mailing Address - Phone:808-953-2121
Mailing Address - Fax:808-524-6618
Practice Address - Street 1:1149 BETHEL ST
Practice Address - Street 2:#509
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2236
Practice Address - Country:US
Practice Address - Phone:808-953-2121
Practice Address - Fax:808-524-6618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-11
Last Update Date:2009-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI479273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI10112009587440OtherACUPUNCTURE