| |
1245 Kuala St, Suite 102a, Pearl City, HI 96782-3900 | |
(808) 726-2161 | |
(808) 726-2161 |
Full Name | |
---|---|
Type | Facility |
Speciality | Podiatrist - Foot & Ankle Surgery |
Location | 1245 Kuala St, Pearl City, Hawaii |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1235549056 | NPI | - | NPPES |
7380140001 | Other | HI | MEDICARE NSC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213ES0103X | Podiatrist - Foot & Ankle Surgery | PO-196 (Hawaii) | Primary |
Mailing Address | Practice Location Address |
---|---|
1245 Kuala St, Suite 102a, Pearl City, HI 96782-3900 Ph: (808) 726-2161 | 1245 Kuala St, Suite 102a, Pearl City, HI 96782-3900 Ph: (808) 726-2161 |
Liane Junko Watanabe, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1245 Kuala St Ste 102a, Pearl City, HI 96782 Phone: 808-726-2161 Fax: 808-726-2163 |