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Organization

SPARK MATSUNAGA VA MEDICAL CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MICHAEL JACKSON (ADMINISTRATIVE OFFICER)
(808) 838-6509
Entity
Organization

Contact information

Practice address
459 PATTERSON ROAD, HONOLULU, HI 96819
(808) 748-1341
Mailing address
459 PATTERSON ROAD, HONOLULU, HI 96819
(808) 748-1341

Taxonomy

Speciality
Code
Description
License number
State
261QV0200X
VA Clinic/Center
Primary
APRN-1831
HI

Other

Enumeration date
09/16/2015
Last updated
09/16/2015
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