Organization
ALFONSO F JIMENEZ
Active
Organization
ALFONSO F JIMENEZ
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALFONSO F JIMENEZ D.O. (OWNER)
(808) 689-4414
Entity
Organization
Contact information
Practice address
91-896 MAKULE RD, SUITE 102, EWA BEACH, HI 96706-2543
(808) 689-4414
(808) 689-7115
Mailing address
91-896 MAKULE RD, SUITE 102, EWA BEACH, HI 96706-2543
(808) 689-4414
(808) 689-7115
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H54601
MEDICARE PROVIDER NUMBER
HI
01
—
H54602
MEDICARE PROVIDER NUMBER
HI
01
—
H54603
MEDICARE PROVIDER NUMBER
HI
Enumeration date
06/01/2007
Last updated
08/26/2008
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