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SUNNYSIDE MEDICAL CLINIC LLC

Ambulatory Health Care Facilities Clinic/Center

Provider NPI: 1407362395

Organization Information:
Organization Name:  SUNNYSIDE MEDICAL CLINIC LLC
Organization is not Subpart
Authorized Official:  MICHELLE  SHANKS  OWNER  808-825-0190

Practice Location:
1005 KEOLU DR STE A  KAILUA, HI 96734-3873 US
Tel: 808-727-1715  Fax: --

Business Mailing Address:
84-740 KILI DR 427 WAIANAE, HI 96792-1509 US
Tel: 808-825-0190  Fax: --

NPI Information:
NPI: 1407362395
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N261Q00000XAmbulatory Health Care Facilities
Clinic/Center
N261QH0100XAmbulatory Health Care Facilities
Clinic/Center
Y261QP2300XAmbulatory Health Care Facilities
Clinic/Center

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 261QP2300X

Type:

Classification:



Definition:



MEDICAL JOBS HI - Page 1

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