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General NPI Number Information
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NPI Number | 1649435330
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Entity Type | Organization
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Legal Business Name | JOSEPHINE WAITE MD LLC
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Dates
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Enumeration Date | 07/23/2008
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Last Update Date | 09/19/2008
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Provider Practice Location Address
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Address Line | 916 KILANI AVE
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City | WAHIAWA
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State | HI
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Zip | 96786-2102
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Country | US
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Telephone | 808-621-5042
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Fax |
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Provider Business Mailing Address
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Address Line | 916 KILANI AVE
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City | WAHIAWA
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State | HI
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Zip | 96786-2102
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Country | US
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Telephone | 808-621-5042
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOSEPHINE DE LA TORRE WAITE
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Credential | MD
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Telephone | 808-247-3609
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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