Provider Demographics
NPI:1124389200
Name:MIS ENDOSCOPY, LLC
Entity Type:Organization
Organization Name:MIS ENDOSCOPY, LLC
Other - Org Name:ENDOSCOPY INSTITUTE OF HAWAII
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUG
Authorized Official - Middle Name:
Authorized Official - Last Name:TONOKAWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-949-2208
Mailing Address - Street 1:1401 S BERETANIA ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1870
Mailing Address - Country:US
Mailing Address - Phone:808-949-2208
Mailing Address - Fax:808-949-2209
Practice Address - Street 1:1401 S BERETANIA ST
Practice Address - Street 2:SUITE 200
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1870
Practice Address - Country:US
Practice Address - Phone:808-949-2208
Practice Address - Fax:808-949-2209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical