Basic Information
| Provider Information | |||||||||
| NPI: | 1093782682 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MBUTHIA | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | WAIRIMU | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6900 GEORGIA AVE NW | ||||||||
| Address2: | DEPT OF ALLERGY.IMMUNOLOGY | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 203070003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2027820411 | ||||||||
| FaxNumber: | 2027824658 | ||||||||
| Practice Location | |||||||||
| Address1: | 1301 PUNCHBOWL ST | ||||||||
| Address2: | |||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968132499 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8086911000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2006 | ||||||||
| LastUpdateDate: | 04/06/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/06/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MD-11847 | HI | N | Allopathic & Osteopathic Physicians | Pediatrics | 207K00000X | MD-11847 | HI | Y | Allopathic & Osteopathic Physicians | Allergy & Immunology |
No ID Information.