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General NPI Number Information
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NPI Number | 1649077447
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Entity Type | Organization
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Legal Business Name | MILILANI GASTRO, LLC
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Dates
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Enumeration Date | 02/27/2025
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 1245 KUALA ST STE 102A
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City | PEARL CITY
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State | HI
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Zip | 96782-3900
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Country | US
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Telephone | 808-272-1889
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Fax | 888-220-7388
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Provider Business Mailing Address
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Address Line | 95-390 KUAHELANI AVE UNIT 4A-1
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City | MILILANI
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State | HI
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Zip | 96789-1192
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Country | US
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Telephone | 808-272-1889
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Fax | 888-220-7388
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Authorized Official
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Title or Position | MANAGER
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Name | MARYSON CABREROS CABUDOY
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Credential | RN, BSN
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Telephone | 808-272-1889
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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