Healthcare Provider Details

I. General information

NPI: 1366005035
Provider Name (Legal Business Name): NATALIE SABINO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2019
Last Update Date: 04/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91-1186 KAIOPUA ST
EWA BEACH HI
96706-5087
US

IV. Provider business mailing address

91-1186 KAIOPUA ST
EWA BEACH HI
96706-5087
US

V. Phone/Fax

Practice location:
  • Phone: 808-754-3466
  • Fax:
Mailing address:
  • Phone: 808-754-3466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number64661
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: