Organization
CDR PLASTIC SURGERY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL LEGASPI DE LOS REYES M.D. (PRESIDENT)
(808) 525-6590
Entity
Organization
Contact information
Practice address
1380 LUSITANA ST STE 904, HONOLULU, HI 96813-2448
(808) 525-6590
(808) 599-8801
Mailing address
4470 SIERRA DR, HONOLULU, HI 96816-4022
(808) 525-6590
(808) 599-8801
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD12235
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
53476002
—
HI
Enumeration date
03/08/2007
Last updated
08/22/2020
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