Ethan Ct Pien Md Llc | |
1010 S King St 111 Honolulu HI 96814-1701 | |
(808) 597-8765 | |
(808) 597-6578 |
Full Name | Ethan Ct Pien Md Llc |
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Speciality | Clinic/Center |
Location | 1010 S King St, Honolulu, Hawaii |
Authorized Official Name and Position | Ethan Pien (OWNER) |
Authorized Official Contact | 8083861866 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Ethan Ct Pien Md Llc 1010 S King St 111 Honolulu HI 96814-1701 Ph: (808) 597-8765 | Ethan Ct Pien Md Llc 1010 S King St 111 Honolulu HI 96814-1701 Ph: (808) 597-8765 |
NPI Number | 1841506565 |
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Provider Enumeration Date | 08/19/2010 |
Last Update Date | 08/19/2010 |
Medicare PECOS PAC ID | 5092857359 |
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Medicare Enrollment ID | O20100125000398 |
Identifier | Type | State | Issuer |
---|---|---|---|
1841506565 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 14017 (Hawaii) | Primary |
Provider Name | Ethan Ct Pien |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1588663454 PECOS PAC ID: 0244285245 Enrollment ID: I20070828000661 |
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