Provider Demographics
NPI:1619356870
Name:PONO CHIROPRACTIC INSTITUTE CORPORATION
Entity type:Organization
Organization Name:PONO CHIROPRACTIC INSTITUTE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARI SIMRAN
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:KHALSA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:808-353-1114
Mailing Address - Street 1:PO BOX 640
Mailing Address - Street 2:
Mailing Address - City:ANAHOLA
Mailing Address - State:HI
Mailing Address - Zip Code:96703-0640
Mailing Address - Country:US
Mailing Address - Phone:808-353-1114
Mailing Address - Fax:
Practice Address - Street 1:4800 KAWAIHAU RD
Practice Address - Street 2:
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-1971
Practice Address - Country:US
Practice Address - Phone:808-353-1114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-21
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1227111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty