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Organization
ISLAND CARDIAC CENTERS LLC
Active
Organization
ISLAND CARDIAC CENTERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDELL PANG (DIRECTOR)
(808) 782-7599
Entity
Organization
Contact information
Practice address
2230 LILIHA ST, HONOLULU, HI 96817-1646
(808) 585-0887
(808) 585-4509
Mailing address
PO BOX 1300, MAIL CODE 60157, HONOLULU, HI 96807-1300
(800) 362-9772
(425) 637-4646
Taxonomy
Speciality
Code
Description
License number
State
2471C1106X
Cardiac-Interventional Technology Radiologic Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000235648
HMSA
HI
01
—
0000235648
HMSA 65C PLUS
—
01
—
50667801
MEDICAID CLASS
—
05
—
50667801
—
HI
01
—
Z1629
MDX
HI
01
—
Z1629
QUEENS MDX
—
Enumeration date
04/18/2006
Last updated
03/12/2009
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