Healthcare Provider Details

I. General information

NPI: 1083308043
Provider Name (Legal Business Name): LAICA MAE BASINGAN ARCIBAL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2023
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89-102 FARRINGTON HWY UNIT 3000
WAIANAE HI
96792-4160
US

IV. Provider business mailing address

89-102 FARRINGTON HWY UNIT 3000
WAIANAE HI
96792-4160
US

V. Phone/Fax

Practice location:
  • Phone: 808-697-3900
  • Fax:
Mailing address:
  • Phone: 808-697-3900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDOS-3043-0
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: