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General NPI Number Information
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NPI Number | 1306598065
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Entity Type | Organization
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Legal Business Name | PERLITA BOLOSAN LAMPITOC MD INC
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Dates
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Enumeration Date | 01/24/2022
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Last Update Date | 01/24/2022
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Provider Practice Location Address
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Address Line | 94-235 HANAWAI CIR STE 8
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City | WAIPAHU
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State | HI
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Zip | 96797-3029
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Country | US
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Telephone | 808-671-8539
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Fax | 808-671-1681
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Provider Business Mailing Address
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Address Line | 94-235 HANAWAI CIR STE 8
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City | WAIPAHU
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State | HI
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Zip | 96797-3029
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Country | US
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Telephone | 808-671-8539
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Fax | 808-671-1681
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PERLITA B MAMPITOC
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Credential | MD
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Telephone | 808-671-8539
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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