NPIMap

Organization Active NPI

MMD

  • Durable Medical Equipment & Medical Supplies
  • Waipahu, HI
National Provider Identifier
1568536787
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
W0423010802 Issued in HI
Legal business name
MMD
Practice address
94-904 Kuakahi St
Waipahu, HI 96797-2808
Phone
(808) 677-4969
Fax
(808) 677-4969
NPI assigned
Nov 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Magdalena A. BaltazarNPI 1114040433
Title
Owner
Phone
(808) 677-4969

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X W0423010802 HI Primary

Addresses

Primary practice location

94-904 Kuakahi St
Waipahu, HI 96797-2808

Mailing address

94-904 Kuakahi St
Waipahu, HI 96797-2808
Phone (808) 677-4969

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1568536787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-904 KUAKAHI ST",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967972808",
            "telephone_number": "808-677-4969",
            "fax_number": "808-677-4969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-904 KUAKAHI ST",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967972808",
            "telephone_number": "808-677-4969",
            "fax_number": "808-677-4969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BALTAZAR",
        "authorized_official_first_name": "MAGDALENA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-677-4969"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "HI",
            "license": "W0423010802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waipahu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.