Basic Information
| Provider Information | |||||||||
| NPI: | 1013961408 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PALI MOMI MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1946 YOUNG ST | ||||||||
| Address2: | SUITE 320 | ||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968262169 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8089737320 | ||||||||
| FaxNumber: | 8089737325 | ||||||||
| Practice Location | |||||||||
| Address1: | 98-1079 MOANALUA RD | ||||||||
| Address2: | |||||||||
| City: | AIEA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967014713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8084866000 | ||||||||
| FaxNumber: | 8084854400 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2006 | ||||||||
| LastUpdateDate: | 06/07/2011 | ||||||||
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| AuthorizedOfficialLastName: | OKABE | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO, SR. VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8085357202 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 37-H | HI | Y | Hospitals | General Acute Care Hospital |
No ID Information.