# HAWAII PODIATRY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Hawaii Podiatry LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235549056
- **Authorized official:** DR. LIANE J WATANABE DPM (OWNER/PRESIDENT)
- **Authorized official phone:** (808) 726-2161

## Contact information

- **Practice address:** 1245 KUALA ST, SUITE 102A, PEARL CITY, HI 96782-3900
- **Practice address phone:** (808) 726-2161
- **Practice address fax:** (808) 726-2161
- **Mailing address:** 1245 KUALA ST, SUITE 102A, PEARL CITY, HI 96782-3900
- **Mailing address phone:** (808) 726-2161
- **Mailing address fax:** (808) 726-2163

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | PO-196 | HI | Yes |

## Other

- **Enumeration date:** 05/01/2014
- **Last updated:** 05/29/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 7380140001 | MEDICARE NSC | HI |