Provider Demographics
NPI:1922022557
Name:HAWAII WOMEN'S HEALTHCARE, LLC
Entity Type:Organization
Organization Name:HAWAII WOMEN'S HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:TANGUILIG RUDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-947-5606
Mailing Address - Street 1:1319 PUNAHOU ST
Mailing Address - Street 2:SUITE 760
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-1001
Mailing Address - Country:US
Mailing Address - Phone:808-947-5606
Mailing Address - Fax:808-948-5805
Practice Address - Street 1:1319 PUNAHOU ST
Practice Address - Street 2:SUITE 760
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1001
Practice Address - Country:US
Practice Address - Phone:808-947-5606
Practice Address - Fax:808-947-5805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI599128Medicaid
HI599128Medicaid