Basic Information
| Provider Information | |||||||||
| NPI: | 1952873325 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SANEKANE | ||||||||
| FirstName: | VINCENT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 79-7199 MAMALAHOA HWY | ||||||||
| Address2: | A-201 | ||||||||
| City: | KAILUA-KONA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 96740 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8084433372 | ||||||||
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| Practice Location | |||||||||
| Address1: | 75-184 HUALALAI RD # 302 | ||||||||
| Address2: | |||||||||
| City: | KAILUA KONA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967401719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8083290111 | ||||||||
| FaxNumber: | 8083655811 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/26/2018 | ||||||||
| LastUpdateDate: | 12/26/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | PTA-451 | HI | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.