Healthcare Provider Details

I. General information

NPI: 1144737925
Provider Name (Legal Business Name): CANCER CENTER OF HAWAII, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2018
Last Update Date: 01/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2226 LILIHA ST, #B2
HONOLULU HI
96817
US

IV. Provider business mailing address

2226 LILIHA ST, #B2
HONOLULU HI
96817
US

V. Phone/Fax

Practice location:
  • Phone: 808-547-6881
  • Fax: 808-547-6583
Mailing address:
  • Phone: 808-547-6881
  • Fax: 808-547-6583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: TANIA ADAMS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 808-628-5706