Individual
TANI K ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 CORAL SEA ST, MEDICAL, KAPOLEI, HI 96707-3693
(808) 682-2673
(808) 682-2779
Mailing address
1 CORAL SEA ST, MEDICAL, KAPOLEI, HI 96707-3693
(808) 682-2673
(808) 682-2779
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
CA
Other
Enumeration date
02/20/2007
Last updated
07/08/2007
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