| NPI | 1457446585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMELIA REYES JACANG Pediatrician 808-522-1313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: HI 1854) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-08-22 |