Provider Demographics
NPI:1942452388
Name:CORTADO, SEAN VINCENT (NONE)
Entity Type:Individual
Prefix:MR
First Name:SEAN
Middle Name:VINCENT
Last Name:CORTADO
Suffix:
Gender:M
Credentials:NONE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 303
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-0303
Mailing Address - Country:US
Mailing Address - Phone:808-398-2744
Mailing Address - Fax:808-678-8180
Practice Address - Street 1:94-260 WAIPAHU DEPOT ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3009
Practice Address - Country:US
Practice Address - Phone:808-398-2744
Practice Address - Fax:808-678-8180
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-16
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIW81270679-01332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies