Individual
TIA HURTADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1136 CALIFORNIA AVE, WAHIAWA, HI 96786-2343
(808) 622-6432
Mailing address
1136 CALIFORNIA AVE, WAHIAWA, HI 96786-2343
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
21-160743
HI
Other
Enumeration date
11/10/2022
Last updated
11/10/2022
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