Provider First Line Business Practice Location Address: 
1356 LUSITANA ST., 4TH FLOOR
    Provider Second Line Business Practice Location Address: 
UH DEPT. OF PSYCHIATRY
    Provider Business Practice Location Address City Name: 
HONOLULU
    Provider Business Practice Location Address State Name: 
HI
    Provider Business Practice Location Address Postal Code: 
96813-2409
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
808-586-2900
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
05/04/2011