Healthcare Provider Details

I. General information

NPI: 1184711913
Provider Name (Legal Business Name): CENTER FOR ALLERGY AND RESPIRATORY DISEASES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 03/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91-2139 FORT WEAVER RD SUITE 303
EWA BEACH HI
96706-3607
US

IV. Provider business mailing address

91-2139 FORT WEAVER RD SUITE 303
EWA BEACH HI
96706-3607
US

V. Phone/Fax

Practice location:
  • Phone: 808-671-1558
  • Fax: 808-677-7072
Mailing address:
  • Phone: 808-671-1558
  • Fax: 808-677-7072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number10430347
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DANILO N. ABLAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 808-671-1558