Provider Demographics
NPI:1114456936
Name:REYES-MONCADA, JASMIN DOMINGO (MD)
Entity Type:Individual
Prefix:
First Name:JASMIN
Middle Name:DOMINGO
Last Name:REYES-MONCADA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JASMIN-ANN
Other - Middle Name:DOMINGO
Other - Last Name:REYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21634 RETREAT PKWY
Mailing Address - Street 2:
Mailing Address - City:TEMESCAL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92883-6100
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1319 PUNAHOU ST STE 824
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1032
Practice Address - Country:US
Practice Address - Phone:808-203-6518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-06
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMDR-7274207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology