Provider Demographics
NPI:1245452911
Name:WESLEY C. WAKAI, M.D., INC.
Entity type:Organization
Organization Name:WESLEY C. WAKAI, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:C
Authorized Official - Last Name:WAKAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-596-0488
Mailing Address - Street 1:1010 SOUTH KING STREET
Mailing Address - Street 2:SUITE 205
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1798
Mailing Address - Country:US
Mailing Address - Phone:808-596-0488
Mailing Address - Fax:808-596-2685
Practice Address - Street 1:1010 SOUTH KING STREET
Practice Address - Street 2:SUITE 205
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1798
Practice Address - Country:US
Practice Address - Phone:808-596-0488
Practice Address - Fax:808-596-2685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-6093207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty