Provider Demographics
NPI:1235203001
Name:ESPINAL, AUGUST GRACE (RD)
Entity Type:Individual
Prefix:MRS
First Name:AUGUST
Middle Name:GRACE
Last Name:ESPINAL
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-510 LUMIAINA ST
Mailing Address - Street 2:#P204
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-5290
Mailing Address - Country:US
Mailing Address - Phone:808-398-8862
Mailing Address - Fax:
Practice Address - Street 1:94-510 LUMIAINA ST
Practice Address - Street 2:#P204
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-5290
Practice Address - Country:US
Practice Address - Phone:808-398-8862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI931288133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI100049Medicare PIN