Alfonso F Jimenez
Organization Active NPI Clinic/Center · Ewa Beach, HI
NPI 1821290917 · NPPES record last updated Aug 26, 2008
Key facts
- NPI
- 1821290917
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- ALFONSO F JIMENEZ
- Practice address
- 91-896 Makule Rd
Suite 102
Ewa Beach, HI 96706-2543 - Phone
- (808) 689-4414
- Fax
- (808) 689-7115
- NPI assigned
- Jun 1, 2007
- Organization subpart
- No
Authorized official
- Name
- Alfonso F Jimenez, D.O.
- Title
- Owner
- Phone
- (808) 689-4414
Practitioners 1
-
Macrina U Vicerra-Jaena, APRN
National Provider Directory
Locations
91-896 Makule Rd
Ste 102
Ewa Beach, HI 96706
Phone (808) 689-4414
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
91-896 Makule Rd
Suite 102
Ewa Beach, HI 96706-2543
Mailing address
91-896 Makule Rd
Suite 102
Ewa Beach, HI 96706-2543
Phone (808) 689-4414
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| H54602 | Other | HI | MEDICARE PROVIDER NUMBER |
| H54603 | Other | HI | MEDICARE PROVIDER NUMBER |
| H54601 | Other | HI | MEDICARE PROVIDER NUMBER |
Other providers in Ewa Beach, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.