21ST CENTURY HEALTHCARE LLC LLC (NPI# 1104152743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104152743 |
| Entity Type | Organization |
| Organization Name | 21ST CENTURY HEALTHCARE LLC LLC |
| Practice Address |
302 California Ave Suite 209 Wahiawa HI 96786-1841 |
| Practice Telephone | 8086222655 |
| Practice Fax Number | 8086225599 |
| Mailing Telephone | 8086222655 |
| Mailing Fax Number | 8086225599 |
| Enumeration Date | 2009-11-01 |
| Last Update Date | 2009-11-01 |
| Authorized Official Name | DR. ARLENE DOROTHY MEYERS (MEMBER) |
| Authorized Official Telephone | 8086222655 |
| Authorized Official Credential | M.D., J.D., M.P. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
302 CALIFORNIA AVE SUITE 209 |
| City | WAHIAWA |
| State | HI |
| Zip Code | 96786-1841 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689675506 | Hugh Norman Hazenfield | Specialist | 302 California Ave, Suite 216, Wahiawa, HI 96786-1841 | 2005-08-02 |
| 1922630292 | Michelle Ushio | Pharmacist | 302 California Ave, Wahiawa, HI 96786-1841 | 2020-02-05 |
| 1689047748 | Paola Wellness LLC | Clinic/Center | 302 California Ave, Suite 202, Wahiawa, HI 96786-1841 | 2015-11-11 |
| 1851780621 | Kawamura Eye Care, LLC | Optometrist | 302 California Ave, Suite 102, Wahiawa, HI 96786-1841 | 2015-01-17 |
| 1891193397 | Jeremiah Shawn Brennan | Counselor | 302 California Ave, Suite 212, Wahiawa, HI 96786-1841 | 2014-12-15 |
| 1043646938 | Vichele A Tavares | Counselor | 302 California Ave, Suite 212, Wahiawa, HI 96786-1841 | 2013-09-24 |
| 1033551478 | Maile Mae Kawano Collado | Physical Therapist | 302 California Ave, Suite 202, Wahiawa, HI 96786-1841 | 2013-07-26 |
| 1285910158 | Elnora Waoala Hiers | Counselor | 302 California Ave, Wahiawa, HI 96786-1841 | 2011-10-24 |
| 1467773846 | Amber K. Gomes | Marriage & Family Therapist | 302 California Ave, Suite 212, Wahiawa, HI 96786-1841 | 2010-06-19 |
| 1023343936 | U S Dermatology of Hawaii Inc | Dermatology | 302 California Ave, Wahiawa, HI 96786-1841 | 2009-10-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801421870 | Macy Tiatti Coleman | Student in an Organized Health Care Education/Training Program | 683 Waianae Ave, Schofield Barracks, HI 96786 | 2020-03-10 |
| 1063078467 | Jacqueline Tommila | Registered Nurse | Wai'anae & Ayres Ave, Wahiawa, HI 96786 | 2019-05-13 |
| 1578126157 | Shantelle Caliboso Bautista | Registered Nurse | Wheeler Army Field, Wahiawa, HI 96786 | 2019-04-18 |
| 1679136246 | Dorinda A Ventura | Licensed Practical Nurse | 1 Wheeler Aaf Wahiawa, Hi 96786, Wahiawa, HI 96786 | 2019-04-18 |
| 1659853950 | Archnaben Patel | Physician Assistant | 3399 Glennan St, Wahiawa, HI 96786 | 2018-09-04 |
| 1245720564 | Zi Xiang Liu | Physician Assistant | 3399 Glennan Street, Schofield Barracks, HI 96786 | 2018-05-11 |
| 1417445503 | Kristine Wong | Occupational Therapist | 1034 Kilani Ave Ste 109, Wahiawa, HI 96786 | 2018-04-25 |
| 1467964528 | Hope Treatment Services | Counselor | 360 California Avenue, Wahiawa, HI 96786 | 2017-10-30 |
| 1881103919 | Testiny K J Mailo | Assistant Behavior Analyst | 1046 Eho Eho Avenue, #326, Wahiawa, HI 96786 | 2017-09-20 |
| 1982121059 | Salvador Mireles Thorn | Physician Assistant | U.S. Army Health Clinic Sb, Building 683, Schofield Barracks, HI 96786 | 2017-08-29 |
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| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912102690 | Donald Fb Char | Pediatrics | 5650 Halepa Pl, Honolulu, HI 96821-2118 | 2007-06-20 |
| 1497701114 | Dwight H Matsumura | Pediatrics | 333 Uluniu St, 103, Kailua, HI 96734-2525 | 2006-05-25 |
| 1225086259 | Naro Luke Torres | Pediatrics | 579 Farrington Hwy, Suite 203, Kapolei, HI 96707-2027 | 2006-05-04 |
| 1467820985 | Frank R. Baum, Md, Inc. | Pediatrics | 200 Kalepa Pl, Kahului, HI 96732-2471 | 2015-09-15 |
| 1245655794 | Marni Lum Dezzani | Pediatrics | 3150 Monsarrat Ave Ste 200, Honolulu, HI 96815-4488 | 2014-02-20 |
| 1336571405 | James Katsuya Nakamura | Pediatrics | 1319 Punahou St, Suite 900, Honolulu, HI 96826-1001 | 2013-07-31 |
| 1447542949 | Christopher Michael Daly | Pediatrics | 1 Jarrett White Rd, Tripler Army Medical Center, HI 96859-5001 | 2011-05-03 |
| 1346547221 | Darrett Choy Md LLC | Pediatrics | 275 Ponahawai St, Suite #106, Hilo, HI 96720-3074 | 2011-02-11 |
| 1134315005 | Brian Wilson Md L.L.C. | Pediatrics | 275 Ponahawai St, Suite 106, Hilo, HI 96720-3074 | 2007-09-24 |
| 1770794554 | Kasi Meredith Chu | Pediatrics | 755 Scott Cir, Jbphh, HI 96853-5399 | 2007-05-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.