1780973461 NPI number — JANICE M PASCUA O.T.

Table of content: JANICE M PASCUA O.T. (NPI 1780973461)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780973461 NPI number — JANICE M PASCUA O.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PASCUA
Provider First Name:
JANICE
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
O.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROBINSON
Provider Other First Name:
JANICE
Provider Other Middle Name:
M
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1780973461
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/01/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 791
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAWAI
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96765-0791
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-634-4234
Provider Business Mailing Address Fax Number:
808-332-5988

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3576 LAHELA PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KALAHEO
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96741-9600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-634-4234
Provider Business Practice Location Address Fax Number:
808-332-5988
Provider Enumeration Date:
04/01/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  OT-90 , 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)