Provider Demographics
NPI:1043727126
Name:FOUNDATION SPINE AND POSTURE LLC
Entity type:Organization
Organization Name:FOUNDATION SPINE AND POSTURE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER /CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:M
Authorized Official - Last Name:NAKAMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:808-376-8937
Mailing Address - Street 1:1150 S. KING ST.
Mailing Address - Street 2:SUITE 408
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1951
Mailing Address - Country:US
Mailing Address - Phone:808-376-8937
Mailing Address - Fax:808-772-4276
Practice Address - Street 1:1150 S. KING ST.
Practice Address - Street 2:SUITE 408
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1951
Practice Address - Country:US
Practice Address - Phone:808-376-8937
Practice Address - Fax:808-772-4276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-10
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDC1380111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty