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General NPI Number Information
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NPI Number | 1407837297
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Entity Type | Individual
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Provider Name | WILLIAM G. CERVANTES MD
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Gender | Male
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Dates
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Enumeration Date | 11/08/2005
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Last Update Date | 08/25/2023
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Provider Practice Location Address
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Address Line | 74-517 HONOKOHAU ST
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City | KAILUA KONA
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State | HI
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Zip | 96740-2715
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Country | US
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Telephone | 808-334-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 74-517 HONOKOHAU ST
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City | KAILUA KONA
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State | HI
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Zip | 96740-2715
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Country | US
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Telephone | 808-334-4400
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | MD9331
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | MD-9331
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License Number State | HI
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