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General NPI Number Information
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NPI Number | 1720267941
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Entity Type | Organization
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Legal Business Name | CARDIOVASCULAR CARE HAWAII, LLC
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Dates
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Enumeration Date | 10/25/2007
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Last Update Date | 04/12/2011
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Provider Practice Location Address
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Address Line | 1029 KAPAHULU AVE SUITE 309
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City | HONOLULU
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State | HI
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Zip | 96816-1332
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Country | US
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Telephone | 808-218-7836
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Fax | 808-218-7882
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Provider Business Mailing Address
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Address Line | 3908 WAOKANAKA ST
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City | HONOLULU
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State | HI
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Zip | 96817-5200
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Country | US
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Telephone | 808-291-3932
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Fax | 808-595-8060
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Authorized Official
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Title or Position | OWNER/MEMBER
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Name | DR. SAMUEL DACANAY
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Credential | MD
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Telephone | 808-291-3932
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD6033
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License Number State | HI
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