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General NPI Number Information
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NPI Number | 1124064621
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Entity Type | Organization
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Legal Business Name | NEPHROLOGY CONSULTANTS
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 08/14/2008
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Provider Practice Location Address
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Address Line | 1380 LUSITANA ST SUITE 814
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City | HONOLULU
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State | HI
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Zip | 96813-2449
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Country | US
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Telephone | 808-521-3802
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Fax | 808-521-1738
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Provider Business Mailing Address
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Address Line | 1380 LUSITANA ST SUITE 814
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City | HONOLULU
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State | HI
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Zip | 96813-2449
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Country | US
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Telephone | 808-521-3802
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Fax | 808-521-1738
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Authorized Official
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Title or Position | PHYSICIAN
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Name | EUGENE WONG
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Credential | M.D.
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Telephone | 808-521-3802
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 1785
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License Number State | HI
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