1952448151 NPI number — PATRICK LONDO

Table of content: PATRICK LONDO (NPI 1952448151)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952448151 NPI number — PATRICK LONDO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LONDO
Provider First Name:
PATRICK
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952448151
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1700 LANAKILA AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96817-2115
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-832-3823
Provider Business Mailing Address Fax Number:
808-832-5850

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3627 KILAUEA AVENUE
Provider Second Line Business Practice Location Address:
411
Provider Business Practice Location Address City Name:
HONOLLU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96816
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-733-9260
Provider Business Practice Location Address Fax Number:
808-733-9187
Provider Enumeration Date:
01/30/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)