Provider Demographics
NPI:1477623833
Name:ROIG, DIEGO (LAC, LMT)
Entity Type:Individual
Prefix:MR
First Name:DIEGO
Middle Name:
Last Name:ROIG
Suffix:
Gender:M
Credentials:LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-229 WAIPAHU DEPOT ST
Mailing Address - Street 2:SUITE 308F
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-3031
Mailing Address - Country:US
Mailing Address - Phone:808-671-8887
Mailing Address - Fax:808-671-8881
Practice Address - Street 1:94-229 WAIPAHU DEPOT ST
Practice Address - Street 2:SUITE 308F
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3031
Practice Address - Country:US
Practice Address - Phone:808-671-8887
Practice Address - Fax:808-671-8881
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI461171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist