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General NPI Number Information
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NPI Number | 1861457376
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Entity Type | Organization
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Legal Business Name | ISLAND CARDIAC CENTERS LLC
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Dates
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Enumeration Date | 04/18/2006
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Last Update Date | 03/12/2009
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Provider Practice Location Address
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Address Line | 2230 LILIHA ST
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City | HONOLULU
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State | HI
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Zip | 96817-1646
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Country | US
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Telephone | 808-585-0887
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Fax | 808-585-4509
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Provider Business Mailing Address
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Address Line | PO BOX 1300 MAIL CODE 60157
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City | HONOLULU
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State | HI
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Zip | 96807-1300
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Country | US
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Telephone | 800-362-9772
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Fax | 425-637-4646
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Authorized Official
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Title or Position | DIRECTOR
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Name | WENDELL PANG
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Credential |
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Telephone | 808-782-7599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471C1106X
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Taxonomy Name | Cardiac-Interventional Technology Radiologic Technologist
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License Number |
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License Number State |
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