Healthcare Provider Details

I. General information

NPI: 1053570150
Provider Name (Legal Business Name): ERIC A. DAGUIO ERIC DAGUIO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ERIC A. DAGUIO ERIC DAGUIO

II. Dates (important events)

Enumeration Date: 06/03/2008
Last Update Date: 06/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94-1306 HUAKAI ST
WAIPAHU HI
96797-3839
US

IV. Provider business mailing address

94-1306 HUAKAI ST
WAIPAHU HI
96797-3839
US

V. Phone/Fax

Practice location:
  • Phone: 808-224-4196
  • Fax:
Mailing address:
  • Phone: 808-224-4196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number4675
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: