PEDIATRIC PROFESSIONALS, INC. (NPI# 1194842674) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194842674 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC PROFESSIONALS, INC. |
| Practice Address |
1350 S King St Ste 300 Honolulu HI 96814-2066 |
| Practice Telephone | 8085939944 |
| Practice Fax Number | 8085930565 |
| Mailing Telephone | 8085939944 |
| Mailing Fax Number | 8085930565 |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. WALLACE J MATTHEWS JR. (PRESIDENT) |
| Authorized Official Telephone | 8085939944 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | MD4255 | HI | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HI | UHA | 02534679801 | 01 |
| HI | HMSA | J4489 | 01 |
| HI | QHMS 2 | 0000004481 | 01 |
| HI | QHCP | MD4255-01 | 01 |
| HI | HMSA 2 | 04481 | 01 |
| HI | HMAI | 192509 | 01 |
| HI | DSS | 00519101 | 01 |
| HI | 00519101 | 05 |
| Street Address |
1350 S KING ST STE 300 |
| City | HONOLULU |
| State | HI |
| Zip Code | 96814-2066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477022267 | Miyuki Hiramatsu | Massage Therapist | 1350 S King St Ste 300, Honolulu, HI 96814-2066 | 2018-11-21 |
| 1811486848 | Holisticare Rehab LLC | Clinic/Center | 1350 S King St Ste 300, Honolulu, HI 96814-2066 | 2018-05-04 |
| 1558878793 | Jie Yan Deng | Massage Therapist | 1350 S King St Ste 300, Honolulu, HI 96814-2066 | 2018-01-09 |
| 1245664929 | Angeline A Tan | Occupational Therapist | 1350 S King St Ste 300, Honolulu, HI 96814-2066 | 2013-08-29 |
| 1760759526 | Catherine Pham Chang | Physical Therapist | 1350 S King St Ste 300, Honolulu, HI 96814-2066 | 2011-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336746478 | Ross Thomas Fujimori Pascual | Pharmacist | 750 Keeaumoku Street, Honolulu, HI 96814 | 2020-10-01 |
| 1336755263 | Hawaikikitelehealth LLC | Counselor | 1108 Auwahi Street, 1506, Honolulu, HI 96814 | 2020-09-16 |
| 1225647324 | Metaphysio Hawaii LLC | Physical Therapist | 1350 South King Street Suite 303, Honolulu, HI 96814 | 2020-07-24 |
| 1114572161 | Alyssa Foster | Social Worker | 1314 S King St Ste 1152, Honolulu, HI 96814 | 2019-08-07 |
| 1871157628 | Ala Moana Walk-in Medical Clinic, Inc | Nurse Practitioner | 410 Atkinson Dr., Level 3, Honolulu, HI 96814 | 2019-04-26 |
| 1528524014 | Regenerative Living Private Duty Inc | Home Health Aide | 1314 South King Street Ste 853, Honolulu, HI 96814 | 2019-02-20 |
| 1295299428 | Kaori Utashiro | Massage Therapist | 1450 Ala Moana Blvd. Suite1227, Honolulu, HI 96814 | 2019-01-22 |
| 1619444569 | Optimized Health LLC | General Practice | 1441 Kapiolani Blvd Ste 1114, #23464, Honolulu, HI 96814 | 2018-10-30 |
| 1356823785 | Tara Yamauchi-lum LLC | Marriage & Family Therapist | 615 Piikoi Street Suite 1109, Honolulu, HI 96814 | 2018-09-01 |
| 1992283980 | Sonia Q. Cosio, D.d.s | Dentist | 1441 Kapiolani Blvd #518, Honolulu, HI 96814 | 2018-08-01 |
| Find all providers in zip 96814 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760925960 | Brandon Allen Greene | Specialist | 1281 S King St, Honolulu, HI 96814-2254 | 2016-11-21 |
| 1013460096 | Julia Vergara | Specialist | 3071 Pualei Cir Apt 202, Honolulu, HI 96815-4933 | 2016-07-26 |
| 1336598051 | Ryan Root | Specialist | 2404 Burbank St, Honolulu, HI 96817-1431 | 2016-06-03 |
| 1043683725 | Jhoan Acosta | Specialist | 1922 Lohilani St, Honolulu, HI 96819-4136 | 2015-11-04 |
| 1689043598 | Randy Hampton | Specialist | 765 Amana St Ste 205, Honolulu, HI 96814-3248 | 2015-09-21 |
| 1922482462 | Dana Dieterich | Specialist | 1949 Naio St, Honolulu, HI 96817-2048 | 2015-07-15 |
| 1780005322 | Philip Su | Specialist | 521 Hahaione St, 10k, Honolulu, HI 96825-1456 | 2013-12-28 |
| 1760810063 | Firstvitals Health and Wellness Inc | Specialist | 1288 Ala Moana Blvd, 27e, Honolulu, HI 96814-4206 | 2013-10-23 |
| 1053654046 | Eugene M Kawaguchi | Specialist | 509 University Ave, #1004, Honolulu, HI 96826-5001 | 2013-03-28 |
| 1407195936 | Sharon S Sakamoto | Specialist | 1401 Ala Aolani St, Honolulu, HI 96819-1404 | 2013-02-04 |
| Find all providers in HONOLULU | ||||
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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.