Provider Demographics
NPI:1790885994
Name:DESILVA, ALAN C (MD INC)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:C
Last Name:DESILVA
Suffix:
Gender:M
Credentials:MD INC
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Mailing Address - Street 1:1248 KINOOLE STREET
Mailing Address - Street 2:SUITE 107
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-4171
Mailing Address - Country:US
Mailing Address - Phone:808-935-6888
Mailing Address - Fax:808-961-0889
Practice Address - Street 1:1248 KINOOLE STREET
Practice Address - Street 2:SUITE 107
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4171
Practice Address - Country:US
Practice Address - Phone:808-935-6888
Practice Address - Fax:808-961-0889
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2019-03-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
HI3482207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G0038OtherBANKERS LIFE & CASUALTY
HI0000044552OtherBLUE CARD HAWAII
HI117987OtherSTATE OF HAWAII DEPT OF E
201361400OtherUS DEPT OF LABOR WORKERS
HI04047901Medicaid
C98746OtherKAISER PERMANENTE SENIOR
HI99022440801OtherCOUNTY OF HAWAII WORKERS
HI0000044552OtherHMSA QUEST NO
HI0000044552OtherHAWAII MEDICAL SERVICE AS
HI0000044552OtherHMSA FED EMPLOYEES PLAN N
HI04047901OtherALOHA CARE
HI19199801OtherHAWAII MEDICAL ASSOCIATIO
HI99022440801OtherCOUNTY OF HAWAII WORKERS
HI0000044552OtherHAWAII MEDICAL SERVICE AS