Organization
MAUI CANCER CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAMIN ALTAHA M.D. (PRESIDENT)
(808) 280-4858
Entity
Organization
Contact information
Practice address
24 NORTH CHURCH STREET SUITE 308, WAILUKU, HI 96793
(808) 242-1110
(855) 839-9759
Mailing address
24 NORTH CHURCH STREET SUITE 308, WAILUKU, HI 96793
(808) 242-1110
(855) 839-9759
Taxonomy
Speciality
Code
Description
License number
State
261QX0200X
Oncology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
68766801
—
HI
Enumeration date
10/17/2014
Last updated
12/03/2015
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