Provider Demographics
NPI:1326391905
Name:CEDRIC S F LORENZO MD INC
Entity Type:Organization
Organization Name:CEDRIC S F LORENZO MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CEDRIC
Authorized Official - Middle Name:SAN FELIPE
Authorized Official - Last Name:LORENZO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-566-6723
Mailing Address - Street 1:1837 KALAKAUA AVE
Mailing Address - Street 2:2009
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-1503
Mailing Address - Country:US
Mailing Address - Phone:808-566-6723
Mailing Address - Fax:808-536-2931
Practice Address - Street 1:1329 LUSITANA ST STE 304
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2411
Practice Address - Country:US
Practice Address - Phone:808-566-6723
Practice Address - Fax:808-536-2931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-19
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-13768208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty