Provider Demographics
NPI:1598343642
Name:MANDING, MIKA GIADA
Entity Type:Individual
Prefix:
First Name:MIKA GIADA
Middle Name:
Last Name:MANDING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92-574 UALEHEI ST
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-1021
Mailing Address - Country:US
Mailing Address - Phone:808-379-8056
Mailing Address - Fax:808-425-4463
Practice Address - Street 1:92-574 UALEHEI ST
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-1021
Practice Address - Country:US
Practice Address - Phone:808-379-8056
Practice Address - Fax:808-425-4463
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care