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General NPI Number Information
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NPI Number | 1952665622
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Entity Type | Organization
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Legal Business Name | BREAST CARE CENTER OF HAWAII LLC
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Dates
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Enumeration Date | 06/27/2012
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Last Update Date | 09/05/2013
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Provider Practice Location Address
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Address Line | 94-229 WAIPAHU DEPOT ST SUITE 308
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City | WAIPAHU
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State | HI
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Zip | 96797-3031
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Country | US
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Telephone | 808-728-1843
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Fax |
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Provider Business Mailing Address
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Address Line | 94-229 WAIPAHU DEPOT ST SUITE 308
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City | WAIPAHU
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State | HI
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Zip | 96797-3031
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Country | US
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Telephone | 808-533-2224
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Fax | 808-524-2227
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BETH A RHODES
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Credential | M.D.
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Telephone | 808-728-1843
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 13002
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License Number State | HI
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