Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 2886 | HI |
NPI | 1144314667 |
---|---|
Provider Name | Dr. Collin Robert Dang |
First Address | Honolulu, HI 96813-2414 |
Second Address | Honolulu, HI 96813-2414 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 06/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03670602 | (05) | HI |
40428 | HMSA (01) | HI |
40428 | HMSA QUEST (01) | HI |
C97371 | (02) | HI |