Individual
MR. SUNNY LI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
16-566 KEAAU PAHOA RD, KEAAU, HI 96749-8137
(808) 765-4400
Mailing address
16-566 KEAAU PAHOA RD # 188-111, KEAAU, HI 96749-8137
(808) 765-4400
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0002407243
—
HI
Enumeration date
04/04/2019
Last updated
04/04/2019
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