Basic Information
| Provider Information | |||||||||
| NPI: | 1437376274 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ECKHART DIESTEL, MD P.L.L.C., P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 142 PAUAHILANI PL | ||||||||
| Address2: | |||||||||
| City: | KAILUA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967343147 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8085424418 | ||||||||
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| Practice Location | |||||||||
| Address1: | 640 ULUKAHIKI ST | ||||||||
| Address2: | |||||||||
| City: | KAILUA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967344454 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8082635500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2007 | ||||||||
| LastUpdateDate: | 07/22/2011 | ||||||||
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| AuthorizedOfficialLastName: | DIESTEL | ||||||||
| AuthorizedOfficialFirstName: | ECKHART | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 8085424418 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0011X | 13525 | HI | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
No ID Information.