Basic Information
Provider Information
NPI: 1609108315
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MAGLINAO
FirstName: THOMAS
MiddleName: LEE
NamePrefix:  
NameSuffix: JR.
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1356 LUSITANA ST FL 7
Address2:  
City: HONOLULU
State: HI
PostalCode: 968132409
CountryCode: US
TelephoneNumber: 8085862910
FaxNumber:  
Practice Location
Address1: 1356 LUSITANA ST FL 7
Address2:  
City: HONOLULU
State: HI
PostalCode: 968132409
CountryCode: US
TelephoneNumber: 8085862910
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/04/2010
LastUpdateDate: 02/04/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMDR5837HIY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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