| Honolulu Psychiatric Sercies Llc | |
|
1188 Bishop St Ste 1102 Honolulu HI 96813-3304 | |
| (808) 388-4969 | |
| Not Available |
| Full Name | Honolulu Psychiatric Sercies Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1188 Bishop St Ste 1102, Honolulu, Hawaii |
| Authorized Official Name and Position | Raymond Davidson (OWNER) |
| Authorized Official Contact | 8083884969 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Honolulu Psychiatric Sercies Llc 1188 Bishop St Ste 1102 Honolulu HI 96813-3304 Ph: () - | Honolulu Psychiatric Sercies Llc 1188 Bishop St Ste 1102 Honolulu HI 96813-3304 Ph: (808) 388-4969 |
| NPI Number | 1942638689 |
|---|---|
| Provider Enumeration Date | 10/16/2013 |
| Last Update Date | 10/16/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942638689 | NPI | - | NPPES |
| 00D0302036 | Medicaid | HI | |
| 77004 | Medicaid | HI | |
| 12101 | Medicaid | HI | |
| 686868 | Medicaid | HI | |
| 691232 | Medicaid | HI | |
| 724246 | Medicaid | HI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 15998 (Hawaii) | Primary |
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | 15998 (Hawaii) | Secondary |
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