Incontrol Diabetes Center, Llc | |
1449 S Beretania St Honolulu HI 96814-1866 | |
(808) 450-2402 | |
(808) 450-2399 |
Full Name | Incontrol Diabetes Center, Llc |
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Speciality | Clinic/Center |
Location | 1449 S Beretania St, Honolulu, Hawaii |
Authorized Official Name and Position | Kevin W K Kam (MEMBER) |
Authorized Official Contact | 8084502402 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Incontrol Diabetes Center, Llc 1449 S Beretania St Honolulu HI 96814-1866 Ph: (808) 450-2402 | Incontrol Diabetes Center, Llc 1449 S Beretania St Honolulu HI 96814-1866 Ph: (808) 450-2402 |
NPI Number | 1235432378 |
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Provider Enumeration Date | 12/13/2010 |
Last Update Date | 12/13/2010 |
Medicare PECOS PAC ID | 4880849314 |
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Medicare Enrollment ID | O20130306000340 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235432378 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Kourtney K Inoue |
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Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1396827473 PECOS PAC ID: 9436165214 Enrollment ID: I20060303000029 |
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