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General NPI Number Information
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NPI Number | 1881602902
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Entity Type | Individual
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Provider Name | CALVIN Y.H. WONG M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 01/06/2017
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Provider Practice Location Address
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Address Line | 1329 LUSITANA ST SUITE 305
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City | HONOLULU
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State | HI
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Zip | 96813-2429
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Country | US
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Telephone | 808-744-4507
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Fax | 808-744-4521
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Provider Business Mailing Address
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Address Line | PO BOX 1300 MAILCODE 47866
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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 | 808-744-4507
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Fax | 808-744-4521
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | MD3902
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License Number State | HI
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