| Manoasta Inc | |
|
400 Hobron Ln # V-3 Honolulu HI 96815-1226 | |
| (808) 913-8840 | |
| Not Available |
| Full Name | Manoasta Inc |
|---|---|
| Speciality | Social Worker |
| Location | 400 Hobron Ln # V-3, Honolulu, Hawaii |
| Authorized Official Name and Position | Hyungbum Kang (CEO) |
| Authorized Official Contact | 8089137741 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Manoasta Inc 1600 Kapiolani Blvd Ste 524 Honolulu HI 96814-3805 Ph: () - | Manoasta Inc 400 Hobron Ln # V-3 Honolulu HI 96815-1226 Ph: (808) 913-8840 |
| NPI Number | 1477277705 |
|---|---|
| Provider Enumeration Date | 09/29/2022 |
| Last Update Date | 09/29/2022 |
| Certification Date | 09/29/2022 |
| Medicare PECOS PAC ID | 6103299771 |
|---|---|
| Medicare Enrollment ID | O20230301001541 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477277705 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Hyesu Shin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437516614 PECOS PAC ID: 4385073519 Enrollment ID: I20200408004774 |
| Provider Name | Hyungbum Kang |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447554787 PECOS PAC ID: 2860890183 Enrollment ID: I20211018000354 |
| Provider Name | Chester Reyes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700161346 PECOS PAC ID: 6800243700 Enrollment ID: I20231115001038 |
| Provider Name | Lisa Casados |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275879777 PECOS PAC ID: 6901257799 Enrollment ID: I20240105001258 |
| Provider Name | Garrett Gomes |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1457076150 PECOS PAC ID: 3274985866 Enrollment ID: I20240118004731 |
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