Healthcare Provider Details

I. General information

NPI: 1619234820
Provider Name (Legal Business Name): LELAND H. DAO, D.O. INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2012
Last Update Date: 12/03/2020
Certification Date: 12/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66-150 KAMEHAMEHA HWY
HALEIWA HI
96712-1440
US

IV. Provider business mailing address

66-150 KAMEHAMEHA HWY
HALEIWA HI
96712-1440
US

V. Phone/Fax

Practice location:
  • Phone: 808-637-8416
  • Fax:
Mailing address:
  • Phone: 808-637-8416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberDOS775
License Number StateHI

VIII. Authorized Official

Name: DR. LELAND HENRY DAO
Title or Position: PRESIDENT
Credential: D.O.
Phone: 80863784176