Provider Demographics
NPI:1720250780
Name:TRAVIS TAIRA D.C., INC.
Entity Type:Organization
Organization Name:TRAVIS TAIRA D.C., INC.
Other - Org Name:TAIRA CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:NAOKI
Authorized Official - Last Name:TAIRA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:808-948-8722
Mailing Address - Street 1:2525 S KING ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-3154
Mailing Address - Country:US
Mailing Address - Phone:808-948-8722
Mailing Address - Fax:808-948-8724
Practice Address - Street 1:2525 S KING ST
Practice Address - Street 2:SUITE 303
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-3154
Practice Address - Country:US
Practice Address - Phone:808-948-8722
Practice Address - Fax:808-948-8724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI967111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIU99037Medicare UPIN
HIH56332Medicare PIN