Basic Information
| Provider Information | |||||||||
| NPI: | 1811189285 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WINDWARD HEART CENTER LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 25490 | ||||||||
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| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968250490 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8085360300 | ||||||||
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| Practice Location | |||||||||
| Address1: | 25 MALUNIU AVE STE 201 | ||||||||
| Address2: | |||||||||
| City: | KAILUA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967345807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8082612441 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2007 | ||||||||
| LastUpdateDate: | 07/02/2009 | ||||||||
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| AuthorizedOfficialLastName: | WONG | ||||||||
| AuthorizedOfficialFirstName: | SONNY | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8083478159 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 5032 | HI | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.