Healthcare Provider Details

I. General information

NPI: 1891835419
Provider Name (Legal Business Name): VICTORIA TORRES CAYABYAB REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94-519 KUPUNA LOOP
WAIPAHU HI
96797-1243
US

IV. Provider business mailing address

94-519 KUPUNA LOOP
WAIPAHU HI
96797-1243
US

V. Phone/Fax

Practice location:
  • Phone: 808-677-9300
  • Fax: 808-678-3839
Mailing address:
  • Phone: 808-677-9300
  • Fax: 808-678-3839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number1821-C
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: