Individual
ALPHA Y RIVERAL III
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
1360 S BERETANIA ST, #215, HONOLULU, HI 96814-1520
(808) 532-3711
(808) 532-3713
Mailing address
142 HAOKEA DR, KAILUA, HI 96734-3215
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD-12259
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000242487
HMSA
—
01
—
540709-01
ACS
—
01
—
A007
CHAMPUS TRICARE
—
Enumeration date
06/25/2006
Last updated
07/08/2007
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