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General NPI Number Information
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NPI Number | 1457548596
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Entity Type | Organization
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Legal Business Name | DAVID G SERIGUCHI, MD INC
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Dates
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Enumeration Date | 10/03/2007
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Last Update Date | 08/14/2008
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Provider Practice Location Address
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Address Line | 1931 E VINEYARD ST SUITE 102
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City | WAILUKU
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State | HI
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Zip | 96793-1700
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Country | US
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Telephone | 808-242-5544
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Fax | 808-242-0068
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Provider Business Mailing Address
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Address Line | 1931 E VINEYARD ST SUITE 102
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City | WAILUKU
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State | HI
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Zip | 96793-1700
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Country | US
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Telephone | 808-242-5544
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Fax | 808-242-0068
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID G SERIGUCHI
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Credential | M.D.
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Telephone | 808-242-5544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | 5286
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License Number State | HI
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