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General NPI Number Information
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NPI Number | 1437661238
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Entity Type | Organization
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Legal Business Name | BYRON CARRASCO DPM LLC
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Dates
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Enumeration Date | 11/02/2017
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 1401 S BERETANIA ST STE 887
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City | HONOLULU
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State | HI
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Zip | 96814-1875
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Country | US
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Telephone | 808-366-8167
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Fax | 855-437-1594
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Provider Business Mailing Address
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Address Line | 46-036 KAMEHAMEHA HWY #1099
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City | KANEOHE
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State | HI
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Zip | 96744-9998
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Country | US
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Telephone | 808-366-8167
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Fax | 844-380-3612
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Authorized Official
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Title or Position | MANAGER
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Name | BYRON R CARRASCO
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Credential | DPM
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Telephone | 808-366-8167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | P0-218
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License Number State | HI
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