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General NPI Number Information
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NPI Number | 1639551146
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Entity Type | Organization
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Legal Business Name | MA. CLARISSE TOLEDO-SANTOS LLC
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Dates
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Enumeration Date | 06/19/2015
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Last Update Date | 06/19/2015
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Provider Practice Location Address
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Address Line | 2226 LILIHA ST SUITE 306
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City | HONOLULU
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State | HI
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Zip | 96817-1600
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Country | US
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Telephone | 808-531-5711
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Fax |
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Provider Business Mailing Address
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Address Line | 2226 LILIHA ST SUITE 306
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City | HONOLULU
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State | HI
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Zip | 96817-1600
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Country | US
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Telephone | 808-531-5711
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Fax |
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Authorized Official
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Title or Position | DR.
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Name | DR. MA CLARISSE TOLEDO SANTOS
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Credential | M.D.
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Telephone | 808-728-6672
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 18034
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License Number State | HI
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