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General NPI Number Information
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NPI Number | 1982946539
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Entity Type | Individual
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Provider Name | CAWIN WONG MIZUBA M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/21/2013
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Last Update Date | 01/17/2017
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Provider Practice Location Address
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Address Line | 377 KEAHOLE ST
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City | HONOLULU
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State | HI
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Zip | 96825-3405
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Country | US
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Telephone | 808-396-6675
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 61972
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City | HONOLULU
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State | HI
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Zip | 96839-1972
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Country | US
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Telephone | 808-389-6921
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD18466
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License Number State | HI
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