| Honolulu Psychiatric Services Llc | |
|
2228 Liliha St Ste 404 Honolulu HI 96817-1654 | |
| (808) 388-4969 | |
| (808) 748-3017 |
| Full Name | Honolulu Psychiatric Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2228 Liliha St Ste 404, Honolulu, Hawaii |
| Authorized Official Name and Position | Raymond Davidson (OWNER) |
| Authorized Official Contact | 8083866851 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Honolulu Psychiatric Services Llc 2228 Liliha St Ste 404 Honolulu HI 96817-1654 Ph: (808) 386-6851 | Honolulu Psychiatric Services Llc 2228 Liliha St Ste 404 Honolulu HI 96817-1654 Ph: (808) 388-4969 |
| NPI Number | 1396017497 |
|---|---|
| Provider Enumeration Date | 02/03/2012 |
| Last Update Date | 03/17/2018 |
| Medicare PECOS PAC ID | 4486818390 |
|---|---|
| Medicare Enrollment ID | O20120605000572 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396017497 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | MD-15998 (Hawaii) | Primary |
| 261QM0850X | Clinic/center - Adult Mental Health | MD159987 (Hawaii) | Secondary |
| Provider Name | Andrea Mieko Chun |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962512954 PECOS PAC ID: 3678757606 Enrollment ID: I20110415000069 |
| Provider Name | Raymond Davidson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790981884 PECOS PAC ID: 3678751302 Enrollment ID: I20110629000269 |
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