Provider Demographics
NPI:1366926313
Name:DOCTORS OF WAIKIKI
Entity type:Organization
Organization Name:DOCTORS OF WAIKIKI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:I
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-376-7278
Mailing Address - Street 1:120 KAIULANI AVE LBBY 10&11
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-6203
Mailing Address - Country:US
Mailing Address - Phone:808-922-2112
Mailing Address - Fax:808-762-3441
Practice Address - Street 1:120 KAIULANI AVE UNIT 10&11
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-6203
Practice Address - Country:US
Practice Address - Phone:808-922-2112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-15
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty