Provider Demographics
NPI:1407893241
Name:WESLEY J. SUGAI, M.D., INC.
Entity Type:Organization
Organization Name:WESLEY J. SUGAI, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE SECRETARY/ACCOUNTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SUGAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-329-7719
Mailing Address - Street 1:81-990 HALEKII ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:KEALAKEKUA
Mailing Address - State:HI
Mailing Address - Zip Code:96750-8155
Mailing Address - Country:US
Mailing Address - Phone:808-329-7719
Mailing Address - Fax:808-329-7518
Practice Address - Street 1:81-990 HALEKII ST
Practice Address - Street 2:SUITE 150
Practice Address - City:KEALAKEKUA
Practice Address - State:HI
Practice Address - Zip Code:96750-8155
Practice Address - Country:US
Practice Address - Phone:808-329-7719
Practice Address - Fax:808-329-7518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-5336208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty