Provider Demographics
NPI:1255942678
Name:ALOHA UROLOGY WEST OAHU LLC
Entity type:Organization
Organization Name:ALOHA UROLOGY WEST OAHU LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMUR
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROYTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-777-4176
Mailing Address - Street 1:1329 LUSITANA ST STE 406
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2412
Mailing Address - Country:US
Mailing Address - Phone:808-599-7779
Mailing Address - Fax:808-599-7780
Practice Address - Street 1:1329 LUSITANA ST STE 406
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2412
Practice Address - Country:US
Practice Address - Phone:808-599-7779
Practice Address - Fax:808-599-7780
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALOHA UROLOGY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty