Healthcare Provider Details

I. General information

NPI: 1841527173
Provider Name (Legal Business Name): CHERYL LYNN TANGUILIG RUDY, M.D. INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2009
Last Update Date: 04/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1319 PUNAHOU ST STE 760
HONOLULU HI
96826-1072
US

IV. Provider business mailing address

1319 PUNAHOU ST SUITE 760
HONOLULU HI
96826-1001
US

V. Phone/Fax

Practice location:
  • Phone: 808-947-5606
  • Fax: 808-947-5805
Mailing address:
  • Phone: 808-947-5606
  • Fax: 808-947-5805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: CHERYL LYNN T RUDY
Title or Position: PRESIDENT
Credential:
Phone: 808-947-5606