Provider Demographics
NPI:1225123185
Name:CADAOAS, CONRAD KEALOHA RICHARD (MPT, ATC)
Entity Type:Individual
Prefix:
First Name:CONRAD
Middle Name:KEALOHA RICHARD
Last Name:CADAOAS
Suffix:
Gender:M
Credentials:MPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-370 PUPUPANI ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-2657
Mailing Address - Country:US
Mailing Address - Phone:808-676-7700
Mailing Address - Fax:808-676-7708
Practice Address - Street 1:94-370 PUPUPANI ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-2657
Practice Address - Country:US
Practice Address - Phone:808-676-7700
Practice Address - Fax:808-676-7708
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI52464Medicare ID - Type Unspecified