PACIFIC CENTRE FOR FAMILY HEALTH AND WELLNESS CORP (NPI# 1285876193) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285876193 |
| Entity Type | Organization |
| Organization Name | PACIFIC CENTRE FOR FAMILY HEALTH AND WELLNESS CORP |
| Practice Address |
4725 Bougainville Dr Pmb528 Honolulu HI 96818-3179 |
| Practice Telephone | 8082920763 |
| Practice Fax Number | 4142479004 |
| Mailing Telephone | 8082920763 |
| Mailing Fax Number | 4142479004 |
| Enumeration Date | 2009-03-24 |
| Last Update Date | 2009-03-24 |
| Authorized Official Name | MR. FRED LEE GOLDBLATT (PRESIDENT) |
| Authorized Official Telephone | 8082920763 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | DOS-515 | HI | Allopathic & Osteopathic Physicians |
| Street Address |
4725 BOUGAINVILLE DR PMB528 |
| City | HONOLULU |
| State | HI |
| Zip Code | 96818-3179 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487631438 | Colleen Mckown-allison | Social Worker | 4725 Bougainville Dr, Pmb: 401, Honolulu, HI 96818-3179 | 2005-12-29 |
| 1346868833 | Janz Corporation | Durable Medical Equipment & Medical Supplies | 4725 Bougainville Dr, Building 631, Honolulu, HI 96818 | 2020-07-10 |
| 1811307093 | Asentra Marketing | Clinic/Center | 4725 Bougainville Dr, Honolulu, HI 96818-3179 | 2014-04-28 |
| 1396173894 | V&d Psychiatry, LLC | Clinic/Center | 4725 Bougainville Dr, #351, Honolulu, HI 96818-3179 | 2013-10-17 |
| 1134341365 | Martin L Crow | General Acute Care Hospital | 4725 Bougainville Dr, Honolulu, HI 96818-3179 | 2007-05-03 |
| 1043356884 | Pearl Harbor Vision Center | Optometrist | 4725 Bougainville Dr, Honolulu, HI 96818-3179 | 2007-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356992457 | Emma Jo Ann Marquez | Military Health Care Provider | 755 Scott Circle Drive, Honolulu, HI 96818 | 2019-09-20 |
| 1497227979 | Melanie Fujii | Behavior Technician | 4510 Salt Lake Boulevard, Suite D-8, Honolulu, HI 96818 | 2018-12-21 |
| 1174016687 | Kerestin Elizabeth Walker | Counselor | 615 Piikoi St, Suite 203, Honolulu, HI 96818 | 2018-06-08 |
| 1598272411 | Juli K Kaaihue | Behavior Technician | 4510 Salt Lake Blvd., D-8, Honolulu, HI 96818 | 2017-12-30 |
| 1861904864 | Joanna Wolford | Licensed Practical Nurse | 1514 Makalapa Drive, Apo, AA 96818 | 2017-10-30 |
| 1093232662 | Lorri Kim Gomes | Social Worker | 1147 Ala Napunani St., #206, Honolulu, HI 96818 | 2017-08-24 |
| 1871960278 | Cassandra Fisher | Speech-Language Pathologist | 202a Beard Ave, Honolulu, HI 96818 | 2015-09-01 |
| 1689073959 | Eanah Whaley | Psychologist | 750 Signer Blvd Bldg 554, Honolulu, HI 96818 | 2014-08-22 |
| 1346599214 | Hawaii Mobility | Durable Medical Equipment & Medical Supplies | 4355 Lawehana #8, Honolulu, HI 96818 | 2012-09-06 |
| 1326303181 | Evelyn Ogami-glary | Massage Therapist | 1780 Bougainvillea Lp, Physical Fitness Center Aliamanu Military Reservation, Honolulu, HI 96818 | 2012-07-09 |
| Find all providers in zip 96818 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225657307 | Healing Tides Primary Care LLC | Family Medicine | 1110 Nuuanu Ave # A1-182, Honolulu, HI 96817-5119 | 2020-04-09 |
| 1669961322 | Micah David | Family Medicine | 1188 Bishop St Ste 802a, Honolulu, HI 96813-3303 | 2018-05-08 |
| 1023469632 | Anh Tan | Family Medicine | 1001 Queen St Ste 102, Honolulu, HI 96814-5243 | 2016-06-24 |
| 1730540659 | Mindy Chen | Family Medicine | 55 S Kukui St Ste C108, Honolulu, HI 96813-2328 | 2016-03-19 |
| 1053703645 | Jane Stephens Fyrberg | Family Medicine | 2459 Parker Place, Honolulu, HI 96822 | 2015-02-19 |
| 1770998726 | Fernando Liquido | Family Medicine | 7192 Kalanianaole Hwy Ste A200, Honolulu, HI 96825-1845 | 2014-06-29 |
| 1275961385 | Gavino T. Vinzons M.d, Inc | Family Medicine | 2055 N. King St. Ste 102, Honolulu, HI 96819 | 2013-10-29 |
| 1609219112 | Emi Ota | Family Medicine | 2250 Kalakaua Ave Ste 407, Honolulu, HI 96815-2546 | 2013-04-15 |
| 1275878050 | Edward Lam | Family Medicine | 1188 Bishop St Ste 3208, Honolulu, HI 96813-3313 | 2012-12-04 |
| 1275893109 | Ilya Vladimir Yepishin | Family Medicine | 736 Hawaii St, Apt. A, Honolulu, HI 96817-7327 | 2012-05-25 |
| Find all providers in HONOLULU | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.