Provider Demographics
NPI:1912784224
Name:HAWAII DIALYSIS PARTNERS WARD LLC
Entity Type:Organization
Organization Name:HAWAII DIALYSIS PARTNERS WARD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:669-236-5953
Mailing Address - Street 1:300 SANTANA ROW STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2424
Mailing Address - Country:US
Mailing Address - Phone:650-404-3600
Mailing Address - Fax:
Practice Address - Street 1:1100 WARD AVE STE 510
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1617
Practice Address - Country:US
Practice Address - Phone:808-460-4953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment