Provider Demographics
NPI:1770699464
Name:ALOHA SURGERY LLC
Entity type:Organization
Organization Name:ALOHA SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:424-206-1919
Mailing Address - Street 1:4348 WAIALAE AVE
Mailing Address - Street 2:#702
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5767
Mailing Address - Country:US
Mailing Address - Phone:424-206-1919
Mailing Address - Fax:310-303-7944
Practice Address - Street 1:928 NUUANU AVE
Practice Address - Street 2:#400
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-5192
Practice Address - Country:US
Practice Address - Phone:808-521-1300
Practice Address - Fax:808-521-1350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-12783208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00A0247245OtherHMSA
HI55302502Medicaid
HI00A0247245OtherHMSA