| NPI | 1669131397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY ESTRANERO TALANA Billing Manager 808-622-1618 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2021-12-09 |
| Last Update Date | 2021-12-09 |