Provider Demographics
NPI:1548003346
Name:OAHU COMMUNITY MEDICINE
Entity type:Organization
Organization Name:OAHU COMMUNITY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTANDER
Authorized Official - Suffix:
Authorized Official - Credentials:DTCM
Authorized Official - Phone:808-501-8176
Mailing Address - Street 1:14 AULIKE ST APT 309
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2700
Mailing Address - Country:US
Mailing Address - Phone:808-501-8176
Mailing Address - Fax:
Practice Address - Street 1:354 ULUNIU ST STE 303
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2533
Practice Address - Country:US
Practice Address - Phone:808-501-8176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty