Provider Demographics
NPI:1467692731
Name:CLINICAL DIAGNOSTIC PARTNERS, LLC
Entity Type:Organization
Organization Name:CLINICAL DIAGNOSTIC PARTNERS, LLC
Other - Org Name:CLINICAL DIAGNOSTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WENDELL
Authorized Official - Middle Name:
Authorized Official - Last Name:PANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-585-7293
Mailing Address - Street 1:1834 NUUANU AVE
Mailing Address - Street 2:#203
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2427
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2226 LILIHA ST
Practice Address - Street 2:#302
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-1600
Practice Address - Country:US
Practice Address - Phone:808-531-2200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-26
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty