Provider Demographics
NPI:1144360116
Name:JAMES H WEHRENBERG MD INC
Entity type:Organization
Organization Name:JAMES H WEHRENBERG MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:WEHRENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-599-8759
Mailing Address - Street 1:1188 BISHOP ST
Mailing Address - Street 2:STE 3411
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3314
Mailing Address - Country:US
Mailing Address - Phone:808-599-8759
Mailing Address - Fax:
Practice Address - Street 1:1188 BISHOP ST
Practice Address - Street 2:STE 3411
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3314
Practice Address - Country:US
Practice Address - Phone:808-599-8759
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD33942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000054544OtherHAWAII MEDICAL SVC ASSN
HI04792601Medicaid
HI04792601Medicaid
HIC98680Medicare UPIN