Provider Demographics
NPI:1750598157
Name:ALOSA, JEREMY S (DC)
Entity type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:S
Last Name:ALOSA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 KAPIOLANI BLVD
Mailing Address - Street 2:201
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-3503
Mailing Address - Country:US
Mailing Address - Phone:808-596-4800
Mailing Address - Fax:808-596-4802
Practice Address - Street 1:1221 KAPIOLANI BLVD
Practice Address - Street 2:201
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3503
Practice Address - Country:US
Practice Address - Phone:808-596-4800
Practice Address - Fax:808-596-4802
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1008111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI100439Medicare ID - Type Unspecified