Provider Demographics
NPI:1235454166
Name:DAN HESLINGA MD LLC
Entity Type:Organization
Organization Name:DAN HESLINGA MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HESLINGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-729-1796
Mailing Address - Street 1:2386 LILOA RISE
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-1953
Mailing Address - Country:US
Mailing Address - Phone:808-729-1796
Mailing Address - Fax:
Practice Address - Street 1:2386 LILOA RISE
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822
Practice Address - Country:US
Practice Address - Phone:808-729-1796
Practice Address - Fax:808-800-2318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-03
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD5742261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care