Healthcare Provider Details

I. General information

NPI: 1215069430
Provider Name (Legal Business Name): THE RADIOLOGY GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 12/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94-800 UKEE STREET SUITE 303
WAIPAHU HI
96797
US

IV. Provider business mailing address

94-800 UKEE STREET SUITE 303
WAIPAHU HI
96797
US

V. Phone/Fax

Practice location:
  • Phone: 808-454-5200
  • Fax: 808-454-5201
Mailing address:
  • Phone: 808-454-5200
  • Fax: 808-454-5201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL CHONG
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 808-954-7835