Organization
FORTUNATO V. ELIZAGA M.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NIEVA G. ELIZAGA (OFFICE MANAGER)
(808) 524-1144
Entity
Organization
Contact information
Practice address
1712 LILIHA ST, SUITE 306, HONOLULU, HI 96817-5410
(808) 524-1144
Mailing address
1712 LILIHA ST STE 306, HONOLULU, HI 96817-3114
(808) 524-1144
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2452
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03406601
—
HI
Enumeration date
08/30/2006
Last updated
08/22/2020
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