Provider Demographics
NPI:1386117927
Name:OHANA SPORTS MEDICINE KAPAA LLC
Entity type:Organization
Organization Name:OHANA SPORTS MEDICINE KAPAA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:SCHAAL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:808-335-5808
Mailing Address - Street 1:4-901 KUHIO HWY STE A
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-1549
Mailing Address - Country:US
Mailing Address - Phone:808-335-5808
Mailing Address - Fax:844-965-9830
Practice Address - Street 1:4-901 KUHIO HWY STE A
Practice Address - Street 2:
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-1549
Practice Address - Country:US
Practice Address - Phone:808-335-5808
Practice Address - Fax:844-965-9830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-07
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Multi-Specialty