Healthcare Provider Details

I. General information

NPI: 1518710029
Provider Name (Legal Business Name): DESIREE GEE SALUD EUGENIO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2024
Last Update Date: 04/08/2024
Certification Date: 04/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

459 PATTERSON RD
HONOLULU HI
96819-1522
US

IV. Provider business mailing address

91-1671 KAPEKU LOOP
EWA BEACH HI
96706-7854
US

V. Phone/Fax

Practice location:
  • Phone: 808-433-0320
  • Fax:
Mailing address:
  • Phone: 808-738-7637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number65491
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: