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General NPI Number Information
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NPI Number | 1942452388
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Entity Type | Individual
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Provider Name | SEAN VINCENT CORTADO NONE
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Gender | Male
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Dates
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Enumeration Date | 10/16/2008
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Last Update Date | 10/05/2010
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Provider Practice Location Address
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Address Line | 94-260 WAIPAHU DEPOT ST
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City | WAIPAHU
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State | HI
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Zip | 96797-3009
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Country | US
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Telephone | 808-398-2744
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Fax | 808-678-8180
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Provider Business Mailing Address
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Address Line | PO BOX 303
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City | PEARL CITY
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State | HI
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Zip | 96782-0303
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Country | US
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Telephone | 808-398-2744
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Fax | 808-678-8180
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | W81270679-01
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License Number State | HI
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