Pacific Centre for Family Health and Wellness Corp

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DOS-515 Issued in HI

Legal business name

PACIFIC CENTRE FOR FAMILY HEALTH AND WELLNESS CORP

Practice address

4725 Bougainville Dr
Pmb528
Honolulu, HI 96818-3179

Phone

(808) 292-0763

Fax

(414) 247-9004

NPI assigned

Mar 24, 2009

Last updated

Mar 24, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Fred Lee Goldblatt, DO

Title

President

Phone

(808) 292-0763

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1237852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237852800000",
    "number": "1285876193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4725 BOUGAINVILLE DR",
            "address_2": "PMB528",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968183179",
            "telephone_number": "808-292-0763",
            "fax_number": "414-247-9004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4725 BOUGAINVILLE DR",
            "address_2": "PMB528",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968183179",
            "telephone_number": "808-292-0763",
            "fax_number": "414-247-9004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC CENTRE FOR FAMILY HEALTH AND WELLNESS CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-24",
        "last_updated": "2009-03-24",
        "status": "A",
        "authorized_official_last_name": "GOLDBLATT",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-292-0763",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "DOS-515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Family Medicine Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.