=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326091224
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOSE TANTOCO ALMEIDA M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/19/2006
-----------------------------------------------------
Last Update Date | 05/29/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 94-673 KUPUOHI ST SUITE 201C
-----------------------------------------------------
City | WAIPAHU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96797-5367
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-387-9477
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 94-673 KUPUOHI ST SUITE C-201
-----------------------------------------------------
City | WAIPAHU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96797-5367
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-983-1671
-----------------------------------------------------
Fax | 808-983-1676
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207P00000X
-----------------------------------------------------
Taxonomy Name | Emergency Medicine Physician
-----------------------------------------------------
License Number | MD13379
-----------------------------------------------------
License Number State | HI
-----------------------------------------------------