Healthcare Provider Details

I. General information

NPI: 1033457452
Provider Name (Legal Business Name): MAGLINAO MEDICAL MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2013
Last Update Date: 01/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 N KUAKINI ST
HONOLULU HI
96817-2336
US

IV. Provider business mailing address

1324 UILA ST
HONOLULU HI
96818-1937
US

V. Phone/Fax

Practice location:
  • Phone: 808-536-2236
  • Fax:
Mailing address:
  • Phone: 808-392-1988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number16756
License Number StateHI

VIII. Authorized Official

Name: THOMAS MAGLINAO
Title or Position: SOLE MEMBER
Credential: MD
Phone: 808-392-1988