Provider Demographics
NPI:1326231333
Name:ASING, DERRICK ALIKA (ATC, CSCS)
Entity Type:Individual
Prefix:
First Name:DERRICK
Middle Name:ALIKA
Last Name:ASING
Suffix:
Gender:M
Credentials:ATC, CSCS
Other - Prefix:
Other - First Name:D.
Other - Middle Name:ALIKA
Other - Last Name:ASING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ATC, CSCS
Mailing Address - Street 1:25 MANU ST
Mailing Address - Street 2:
Mailing Address - City:KULA
Mailing Address - State:HI
Mailing Address - Zip Code:96790-8519
Mailing Address - Country:US
Mailing Address - Phone:808-357-4125
Mailing Address - Fax:
Practice Address - Street 1:25 MANU ST
Practice Address - Street 2:
Practice Address - City:KULA
Practice Address - State:HI
Practice Address - Zip Code:96790-8519
Practice Address - Country:US
Practice Address - Phone:808-357-4125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer