Provider Demographics
NPI:1003242637
Name:EMILY DIEP, M.D., LLC
Entity Type:Organization
Organization Name:EMILY DIEP, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:DIEP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-523-6461
Mailing Address - Street 1:321 N KUAKINI ST
Mailing Address - Street 2:SUITE NUMBER 715
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2364
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:321 N KUAKINI ST
Practice Address - Street 2:SUITE NUMBER 715
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2364
Practice Address - Country:US
Practice Address - Phone:808-523-6461
Practice Address - Fax:808-550-0466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-14
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI15556207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty