Provider Demographics
NPI:1811124985
Name:BARIATRIC AND MINIMALLY INVASIVE SURGERY OF HAWAII
Entity type:Organization
Organization Name:BARIATRIC AND MINIMALLY INVASIVE SURGERY OF HAWAII
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHARAN
Authorized Official - Middle Name:KAUR
Authorized Official - Last Name:MANHAS-PRAKASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-294-4401
Mailing Address - Street 1:PO BOX 4636
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96812-4636
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1301 PUNCHBOWL ST
Practice Address - Street 2:C/O WOUND CARE CLINIC
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2402
Practice Address - Country:US
Practice Address - Phone:310-194-4401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-16
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty