Healthcare Provider Details
I. General information
NPI: 1912278128
Provider Name (Legal Business Name): RCMD INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/19/2012
Last Update Date: 01/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
640 ULUKAHIKI ST
KAILUA HI
96734-4454
US
IV. Provider business mailing address
PO BOX 25370
HONOLULU HI
96825-0370
US
V. Phone/Fax
- Phone: 808-263-5500
- Fax:
- Phone: 808-536-0300
- Fax: 808-536-0320
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | MD-13251 |
| License Number State | HI |
VIII. Authorized Official
Name:
ROMAN
CORTEZ
Title or Position: OWNER
Credential: M.D.
Phone: 808-561-0314