Basic Information
| Provider Information | |||||||||
| NPI: | 1508525569 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CUESTAS | ||||||||
| FirstName: | CHARLOTTE | ||||||||
| MiddleName: | MEI-WEI | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1243 ALA KAPUNA ST APT 121 | ||||||||
| Address2: | |||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968191279 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8087416501 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1001 KAMOKILA BLVD STE 210 | ||||||||
| Address2: | |||||||||
| City: | KAPOLEI | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967072096 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8085916060 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/16/2021 | ||||||||
| LastUpdateDate: | 12/16/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | HI | Y |
No ID Information.