# ELAM SPORTS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Elam Sports Oahu
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770512048
- **Authorized official:** CHANDRA L ELAM (COMPANY OFFICER)
- **Authorized official phone:** (808) 674-9595

## Contact information

- **Practice address:** 425 KAMEHAMEHA HWY, SUITE 2B, PEARL CITY, HI 96782-3238
- **Practice address phone:** (808) 674-9595
- **Practice address fax:** (808) 674-9696
- **Mailing address:** 1001 KAMOKILA BLVD, SUITE 111 JCB, KAPOLEI, HI 96707-2014
- **Mailing address phone:** (808) 674-9595
- **Mailing address fax:** (808) 674-9696

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 06/30/2006
- **Last updated:** 11/27/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 50320201 | — | HI |
| 01 | — | A218931 | HMSA | HI |