Provider Demographics
NPI:1629402060
Name:BENEDICTO R. GALINDO, M.D., INC.
Entity type:Organization
Organization Name:BENEDICTO R. GALINDO, M.D., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BENEDICTO
Authorized Official - Middle Name:R
Authorized Official - Last Name:GALINDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-676-0865
Mailing Address - Street 1:94-366 PUPUPANI STREET
Mailing Address - Street 2:SUITE 118
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-2644
Mailing Address - Country:US
Mailing Address - Phone:808-676-0865
Mailing Address - Fax:808-676-1970
Practice Address - Street 1:94-366 PUPUPANI STREET
Practice Address - Street 2:SUITE 118
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-2644
Practice Address - Country:US
Practice Address - Phone:808-676-0865
Practice Address - Fax:808-676-1970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-6605208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI04248101Medicaid
HI04248101Medicaid