Organization
SUTTER HEALTH PACIFIC
Active
Other names
Kahi Mohala Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MARK R. MITCHELL PH.D. (CHIEF EXECUTIVE OFFICER)
(808) 671-8511
Entity
Organization
Contact information
Practice address
91-2301 FORT WEAVER RD, EWA BEACH, HI 96706-3602
(808) 671-8511
(808) 677-2570
Mailing address
91-2301 FORT WEAVER RD, EWA BEACH, HI 96706-3602
(808) 671-8511
(808) 677-2570
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
33-H
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0006220245
AETNA
HI
05
—
508129
—
HI
Enumeration date
04/24/2006
Last updated
04/20/2008
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