Provider Demographics
NPI:1932468626
Name:TANGI, ROBERT MAMARIL JR
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:MAMARIL
Last Name:TANGI
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95-021 KUAHELANI AVENUE
Mailing Address - Street 2:203
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789
Mailing Address - Country:US
Mailing Address - Phone:808-781-6338
Mailing Address - Fax:
Practice Address - Street 1:95-021 KUAHELANI AVE
Practice Address - Street 2:203
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-1666
Practice Address - Country:US
Practice Address - Phone:808-781-6338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-15
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator