Provider Demographics
NPI:1548336183
Name:HAWAII ANESTHESIA GROUP INC
Entity type:Organization
Organization Name:HAWAII ANESTHESIA GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:AUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-946-1712
Mailing Address - Street 1:1575 SOUTH BERETANIA STREET
Mailing Address - Street 2:#201 & 202
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-1149
Mailing Address - Country:US
Mailing Address - Phone:808-946-1712
Mailing Address - Fax:808-946-1728
Practice Address - Street 1:1575 SOUTH BERETANIA STREET
Practice Address - Street 2:#201 & 202
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1149
Practice Address - Country:US
Practice Address - Phone:808-946-1712
Practice Address - Fax:808-946-1728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI04186501Medicaid
HI04186501Medicaid