| Sweet Manoa Llc | |
|
1050 Queen St Ste 100 Honolulu HI 96814-4130 | |
| (808) 913-8840 | |
| Not Available |
| Full Name | Sweet Manoa Llc |
|---|---|
| Speciality | Counselor |
| Location | 1050 Queen St Ste 100, Honolulu, Hawaii |
| Authorized Official Name and Position | Hyungbum Kang (DIRECTOR) |
| Authorized Official Contact | 8089138840 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sweet Manoa Llc 909 Kapiolani Blvd Apt 1603 Honolulu HI 96814-2139 Ph: (808) 913-8840 | Sweet Manoa Llc 1050 Queen St Ste 100 Honolulu HI 96814-4130 Ph: (808) 913-8840 |
| NPI Number | 1730781394 |
|---|---|
| Provider Enumeration Date | 11/09/2020 |
| Last Update Date | 11/09/2020 |
| Certification Date | 11/09/2020 |
| Medicare PECOS PAC ID | 9638569544 |
|---|---|
| Medicare Enrollment ID | O20211208003289 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730781394 | NPI | - | NPPES |
| Provider Name | Hyungbum Kang |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447554787 PECOS PAC ID: 2860890183 Enrollment ID: I20211018000354 |
| Provider Name | Chester Reyes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700161346 PECOS PAC ID: 6800243700 Enrollment ID: I20231115001038 |
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