Owen K. Nishikawa M.d., Llc | |
321 N Kuakini St Suite 304 Honolulu HI 96817-2364 | |
(808) 536-5383 | |
(808) 526-0877 |
Full Name | Owen K. Nishikawa M.d., Llc |
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Speciality | Family Medicine |
Location | 321 N Kuakini St, Honolulu, Hawaii |
Authorized Official Name and Position | Owen Koh Nishikawa (OWNER) |
Authorized Official Contact | 8085365383 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Owen K. Nishikawa M.d., Llc 321 N Kuakini St Suite 304 Honolulu HI 96817-2364 Ph: (808) 536-5383 | Owen K. Nishikawa M.d., Llc 321 N Kuakini St Suite 304 Honolulu HI 96817-2364 Ph: (808) 536-5383 |
NPI Number | 1407192750 |
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Provider Enumeration Date | 12/13/2012 |
Last Update Date | 12/13/2012 |
Medicare PECOS PAC ID | 5092952325 |
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Medicare Enrollment ID | O20130506000234 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407192750 | NPI | - | NPPES |
1053471797 | Other | INDIVIDUAL NPI NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Owen K Nishikawa |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1053471797 PECOS PAC ID: 4284623612 Enrollment ID: I20040510001484 |
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