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General NPI Number Information
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NPI Number | 1598611618
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Entity Type | Organization
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Legal Business Name | MANDALAY CLINIC LLC
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Dates
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Enumeration Date | 03/10/2026
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Last Update Date | 03/10/2026
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Provider Practice Location Address
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Address Line | 928 NUUANU AVE LOWR LEVEL
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City | HONOLULU
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State | HI
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Zip | 96817-5193
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Country | US
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Telephone | 315-547-0502
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Fax |
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Provider Business Mailing Address
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Address Line | 355 FALLBROOK CT
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City | SCHAUMBURG
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State | IL
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Zip | 60194-4933
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Country | US
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Telephone | 315-547-0502
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MYA YEE NANDAR
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Credential | PMHNP
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Telephone | 315-547-0502
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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