Provider Demographics
NPI:1720267941
Name:CARDIOVASCULAR CARE HAWAII, LLC
Entity Type:Organization
Organization Name:CARDIOVASCULAR CARE HAWAII, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DACANAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-291-3932
Mailing Address - Street 1:3908 WAOKANAKA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-5200
Mailing Address - Country:US
Mailing Address - Phone:808-291-3932
Mailing Address - Fax:808-595-8060
Practice Address - Street 1:1029 KAPAHULU AVE
Practice Address - Street 2:SUITE 309
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-1332
Practice Address - Country:US
Practice Address - Phone:808-218-7836
Practice Address - Fax:808-218-7882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD6033207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty