1528396686 NPI number — SOOTHING SHEN ACUPUNCTURE

Table of content: (NPI 1528396686)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528396686 NPI number — SOOTHING SHEN ACUPUNCTURE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOOTHING SHEN ACUPUNCTURE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
THERESA J. ALVILLAR
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528396686
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/01/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1122 WILDER AVE
Provider Second Line Business Mailing Address:
#108
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96822-2778
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-688-6552
Provider Business Mailing Address Fax Number:
808-545-1191

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 N BERETANIA ST
Provider Second Line Business Practice Location Address:
#203 B
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96817-4712
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-521-2288
Provider Business Practice Location Address Fax Number:
808-521-2277
Provider Enumeration Date:
12/01/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ALVILLAR
Authorized Official First Name:
THERESA
Authorized Official Middle Name:
J
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
808-688-6552

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  910 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)