| Manoa Family Practice LLC | |
|
2756 Woodlawn Dr Ste 6-202 Honolulu HI 96822-1856 | |
| (808) 988-8880 | |
| Not Available |
| Full Name | Manoa Family Practice LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 2756 Woodlawn Dr Ste 6-202, Honolulu, Hawaii |
| Authorized Official Name and Position | Alicia Knowles (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8084926751 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Manoa Family Practice LLC 4348 Waialae Ave Ste 769 Honolulu HI 96816-5767 | Manoa Family Practice LLC 2756 Woodlawn Dr Ste 6-202 Honolulu HI 96822-1856 Ph: (808) 988-8880 |
| NPI Number | 1811788961 |
|---|---|
| Provider Enumeration Date | 05/16/2025 |
| Last Update Date | 09/18/2025 |
| Certification Date | 09/18/2025 |
| Medicare PECOS PAC ID | 6305346677 |
|---|---|
| Medicare Enrollment ID | O20250821002197 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811788961 | NPI | - | NPPES |
| 2668800178 | Medicaid | HI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | Primary |
| Provider Name | Alicia Knowles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952933855 PECOS PAC ID: 2668800178 Enrollment ID: I20200403002916 |
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