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21st Century Healthcare LLC LLC

Pediatrics, Adolescent Medicine in Wahiawa, HI. Organization (NPI-2).

NPI number1104152743
StatusActive
Last updated in NPPESNov 1, 2009

Details

NPI
1104152743
Entity type
Organization (NPI-2)
Legal business name
21st Century Healthcare LLC LLC
Organization subpart
No
Enumeration date
Nov 1, 2009
Last updated
Nov 1, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2080A0000X Pediatrics, Adolescent Medicine––Yes
207R00000X Internal Medicine––

Practice location

302 California Ave
Suite 209
Wahiawa, HI 96786-1841

Phone 808-622-2655 · Fax 808-622-5599

Mailing address

302 California Ave
Suite 209
Wahiawa, HI 96786-1841

Phone 808-622-2655 · Fax 808-622-5599

Authorized official

Arlene Dorothy Meyers
Member
8086222655

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