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General NPI Number Information
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NPI Number | 1356601181
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Entity Type | Organization
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Legal Business Name | PERSONALIZED CANCER MEDICINE, PLLC
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Dates
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Enumeration Date | 05/27/2012
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Last Update Date | 05/27/2012
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Provider Practice Location Address
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Address Line | 1329 LUSITANA ST SUITE 609
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City | HONOLULU
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State | HI
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Zip | 96813-2429
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Country | US
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Telephone | 808-521-0100
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Fax | 866-438-6310
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Provider Business Mailing Address
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Address Line | 1329 LUSITANA ST SUITE 609
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City | HONOLULU
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State | HI
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Zip | 96813-2429
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Country | US
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Telephone | 808-521-0100
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Fax | 866-438-6310
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Authorized Official
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Title or Position | OWNER/ONCOLOGIST
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Name | MICHAEL PATRICK CASTRO
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Credential | M.D.
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Telephone | 808-521-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 15323
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License Number State | HI
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