Provider Demographics
NPI:1811166390
Name:AUDIE ASISTIN, M.D., INC
Entity type:Organization
Organization Name:AUDIE ASISTIN, M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AUDIE
Authorized Official - Middle Name:PIZARRO
Authorized Official - Last Name:ASISTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-678-7061
Mailing Address - Street 1:PO BOX 700309
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96709-0309
Mailing Address - Country:US
Mailing Address - Phone:808-203-7943
Mailing Address - Fax:808-693-8060
Practice Address - Street 1:91-2141 FORT WEAVER RD
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-1993
Practice Address - Country:US
Practice Address - Phone:808-678-7061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI49608501Medicaid
HIH56015Medicare PIN