Carolina D. Davide, M.D. Inc
Organization Active NPI Primary Care Clinic/Center · Waianae, HI
NPI 1083904262 · NPPES record last updated Nov 23, 2024
Key facts
- NPI
- 1083904262
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- License
- 12910 (HI)
- Legal business name
- CAROLINA D. DAVIDE, M.D. INC
- Practice address
- 85-910 Farrington Hwy
Suite 102
Waianae, HI 96792-2651 - Phone
- (808) 696-4044
- Fax
- (808) 696-4009
- NPI assigned
- Apr 8, 2011
- Organization subpart
- No
Authorized official
- Name
- Dr. Carolina Dominica Davide, M.D.
- Title
- M.D.
- Phone
- (808) 696-4044
Practitioners 1
-
Carolina Dominica Davide, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in HI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110809000582 | HI | Part B Supplier - Clinic/Group Practice | 9537338561 |
Receives reassigned benefits from 1 practitioner Practice locations: Waianae, HI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | 12910 | HI | Yes |
Addresses
Primary practice location
85-910 Farrington Hwy
Suite 102
Waianae, HI 96792-2651
Mailing address
85-910 Farrington Hwy
Suite 102
Waianae, HI 96792-2651
Phone (808) 696-4044
Other providers in Waianae, HI
- Kevin M Calleon
- Fredrene Caminos
- Caregivers of Hawaii
- Caring Options LLC
- Nicole Carlson
- Delano Carroll Jr.
- Guillermo Christian Castro
- Ashley Nicole Aquino Catapang
- Stefanie K. Y. Chang-Hiu
- Martha Halaulani-Kauhi Chang
All providers in Waianae, HI · Primary Care Clinic/Center in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.