| Incontrol Diabetes Center, Llc | |
|
1449 S Beretania St Honolulu HI 96814-1866 | |
| (808) 450-2402 | |
| (808) 450-2399 |
| Full Name | Incontrol Diabetes Center, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1449 S Beretania St, Honolulu, Hawaii |
| Authorized Official Name and Position | Kevin W K Kam (MEMBER) |
| Authorized Official Contact | 8084502402 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Incontrol Diabetes Center, Llc 1449 S Beretania St Honolulu HI 96814-1866 Ph: (808) 450-2402 | Incontrol Diabetes Center, Llc 1449 S Beretania St Honolulu HI 96814-1866 Ph: (808) 450-2402 |
| NPI Number | 1235432378 |
|---|---|
| Provider Enumeration Date | 12/13/2010 |
| Last Update Date | 12/13/2010 |
| Medicare PECOS PAC ID | 4880849314 |
|---|---|
| Medicare Enrollment ID | O20130306000340 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235432378 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Kourtney K Inoue |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1396827473 PECOS PAC ID: 9436165214 Enrollment ID: I20060303000029 |
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