| Venture Medical 21 Inc | |
|
91-896 Makule Rd Ste 102 Ewa Beach HI 96706-2543 | |
| (808) 689-4414 | |
| (808) 689-7115 |
| Full Name | Venture Medical 21 Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 91-896 Makule Rd Ste 102, Ewa Beach, Hawaii |
| Authorized Official Name and Position | Jose D Reque (PRESIDENT) |
| Authorized Official Contact | 8085317878 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Venture Medical 21 Inc 810 Richards St Ste 990 Honolulu HI 96813-4722 Ph: (808) 531-7878 | Venture Medical 21 Inc 91-896 Makule Rd Ste 102 Ewa Beach HI 96706-2543 Ph: (808) 689-4414 |
| NPI Number | 1851647952 |
|---|---|
| Provider Enumeration Date | 07/26/2012 |
| Last Update Date | 08/15/2014 |
| Medicare PECOS PAC ID | 7810147832 |
|---|---|
| Medicare Enrollment ID | O20121026000580 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851647952 | NPI | - | NPPES |
| W8141213401 | Other | HI | STATE OF HAWAII |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Jose C De Leon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275639866 PECOS PAC ID: 3870519036 Enrollment ID: I20051018000569 |
| Provider Name | Macrina U Vicerra-jaena |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992758015 PECOS PAC ID: 0547410490 Enrollment ID: I20121030000447 |
| Provider Name | Jacqueline Y Chacon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023376779 PECOS PAC ID: 5799936076 Enrollment ID: I20121114000299 |
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Empower Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 91-6390 Kapolei Pkwy, Ewa Beach, HI 96706 Phone: 808-691-4600 | |
Access Medical Clinics Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 91-1401 Fort Weaver Rd, Ewa Beach, HI 96706 Phone: 808-285-2448 | |
West Oahu Acupuncture And Integrative Medicine Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 91-1123 Keaunui Dr Ste 223, Ewa Beach, HI 96706 Phone: 808-638-4559 Fax: 781-998-2412 | |
Waianae District Comprehensive Health And Hospital Board, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 91-1841 Fort Weaver Rd, Ewa Beach, HI 96706 Phone: 808-697-3300 | |
Rachel Tortolini Md,llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 91-896 Makule Rd Ste 102, Ewa Beach, HI 96706 Phone: 808-689-4414 Fax: 808-689-7115 |