Provider Demographics
NPI:1811907926
Name:ELI, IRWIN P (DC)
Entity type:Individual
Prefix:
First Name:IRWIN
Middle Name:P
Last Name:ELI
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 1:95 MAHALANI ST
Mailing Address - Street 2:SUITE 21
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793
Mailing Address - Country:US
Mailing Address - Phone:808-244-4676
Mailing Address - Fax:808-242-6676
Practice Address - Street 1:95 MAHALANI ST
Practice Address - Street 2:SUITE 21
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793
Practice Address - Country:US
Practice Address - Phone:808-244-4676
Practice Address - Fax:808-242-6676
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDC45111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor