Provider Demographics
NPI:1750936191
Name:MUA, ALEXANDER MALACHI
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:MALACHI
Last Name:MUA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46-232 KAHUHIPA ST APT E104
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-3920
Mailing Address - Country:US
Mailing Address - Phone:415-216-7245
Mailing Address - Fax:
Practice Address - Street 1:46-232 KAHUHIPA ST APT E104
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-3920
Practice Address - Country:US
Practice Address - Phone:415-216-7245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-02
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRN-87889163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool