Provider Demographics
NPI:1215326509
Name:HOLISTICARE PHYSICAL THERAPY
Entity type:Organization
Organization Name:HOLISTICARE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:YING-WEI
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:808-348-6336
Mailing Address - Street 1:400 KEAWE ST # 416
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-5199
Mailing Address - Country:US
Mailing Address - Phone:808-348-6336
Mailing Address - Fax:
Practice Address - Street 1:400 KEAWE ST # 416
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-5199
Practice Address - Country:US
Practice Address - Phone:808-348-6336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-09
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIFZ348ZCAMedicare UPIN