Provider Demographics
NPI:1730112160
Name:DEL ROSARIO, NESTOR ISIDRO CONCEPCION (MD)
Entity Type:Individual
Prefix:
First Name:NESTOR ISIDRO
Middle Name:CONCEPCION
Last Name:DEL ROSARIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-939 KAHUAILANI ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-3326
Mailing Address - Country:US
Mailing Address - Phone:808-671-5681
Mailing Address - Fax:808-671-5276
Practice Address - Street 1:94-939 KAHUAILANI ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3326
Practice Address - Country:US
Practice Address - Phone:808-671-5681
Practice Address - Fax:808-671-5276
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-9599207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI08053001Medicaid
HIGO579ZOtherMEDICARE ID
HIGO579ZOtherMEDICARE ID
HI0000BFDGZMedicare ID - Type Unspecified