Mango Foundation, Inc.

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

MANGO FOUNDATION, INC.

Practice address

64-1032 Mamalahoa Hwy
Suite 306
Kamuela, HI 96743-8441

Phone

(808) 769-5010

NPI assigned

Nov 14, 2016

Last updated

Nov 14, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Timothy Duerler

Title

Board of Director

Phone

(808) 351-6836

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1479081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479081600000",
    "number": "1063954634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64-1032 MAMALAHOA HWY",
            "address_2": "SUITE 306",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967438441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64-1032 MAMALAHOA HWY",
            "address_2": "SUITE 306",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967438441",
            "telephone_number": "808-769-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANGO FOUNDATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-14",
        "last_updated": "2016-11-14",
        "status": "A",
        "authorized_official_last_name": "DUERLER",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "BOARD OF DIRECTOR",
        "authorized_official_telephone_number": "808-351-6836"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Kamuela, HI
• Providers in Kamuela, HI by specialty
• Multi-Specialty Clinic/Center in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.