Provider Demographics
NPI:1710168265
Name:EDWARD A. ALQUERO, M.D., INC.
Entity Type:Organization
Organization Name:EDWARD A. ALQUERO, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALQUERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-676-2271
Mailing Address - Street 1:94-141 PUPUPUHI ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-2510
Mailing Address - Country:US
Mailing Address - Phone:808-676-2271
Mailing Address - Fax:
Practice Address - Street 1:94-141 PUPUPUHI ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-2510
Practice Address - Country:US
Practice Address - Phone:808-676-2271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-26
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI54426Medicare PIN