Provider Demographics
NPI:1417213414
Name:KAUAI ONCOLOGY, LLC
Entity Type:Organization
Organization Name:KAUAI ONCOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SALEEM
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHMOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-241-4300
Mailing Address - Street 1:4388 PAHEE STREET
Mailing Address - Street 2:
Mailing Address - City:LIHUE, KAUAI
Mailing Address - State:HI
Mailing Address - Zip Code:96766-2029
Mailing Address - Country:US
Mailing Address - Phone:808-241-4300
Mailing Address - Fax:808-241-4301
Practice Address - Street 1:4388 PAHEE STREET
Practice Address - Street 2:
Practice Address - City:LIHUE, KAUAI
Practice Address - State:HI
Practice Address - Zip Code:96766
Practice Address - Country:US
Practice Address - Phone:808-241-4300
Practice Address - Fax:808-241-4301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-04
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty