Basic Information
| Provider Information | |||||||||
| NPI: | 1801843198 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HAWAII EMERGENCY PHYSICIANS ASSOCIATED INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | HEPA, INC. | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1266 | ||||||||
| Address2: | |||||||||
| City: | KAILUA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967341266 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8082613326 | ||||||||
| FaxNumber: | 8082634604 | ||||||||
| Practice Location | |||||||||
| Address1: | 407 ULUNIU ST | ||||||||
| Address2: | 4TH FLOOR | ||||||||
| City: | KAILUA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967342519 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8082613326 | ||||||||
| FaxNumber: | 8082634604 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2006 | ||||||||
| LastUpdateDate: | 04/10/2008 | ||||||||
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| AuthorizedOfficialLastName: | THOMAS | ||||||||
| AuthorizedOfficialFirstName: | CRAIG | ||||||||
| AuthorizedOfficialMiddleName: | S. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8082261048 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | HEPA70 | 01 | HI | MEDICARE PTAN | OTHER | 046980 01 | 05 | HI | MEDICAID | 0000053397 | 01 | HI | HMSA | OTHER |