Provider Demographics
NPI:1043970767
Name:PASAMONTE, MILA (CNA)
Entity Type:Individual
Prefix:
First Name:MILA
Middle Name:
Last Name:PASAMONTE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-1172 KAHUAHALE ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-3503
Mailing Address - Country:US
Mailing Address - Phone:808-913-9913
Mailing Address - Fax:
Practice Address - Street 1:94-1172 KAHUAHALE ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3503
Practice Address - Country:US
Practice Address - Phone:808-913-9913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-21
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1-210077311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home