Edward Franklin De Deo, D.C.
Individual provider Active NPI Chiropractor · Koloa, HI
NPI 1801980339 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1801980339
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 410 (HI)
- Practice address
- 5470 Koloa Rd 2D
Koloa, HI 96756-0388 - Phone
- (808) 742-2055
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 410 | HI | MD | Gerontology Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 410 | HI | Yes |
Addresses
Primary practice location
5470 Koloa Rd 2D
Koloa, HI 96756-0388
Mailing address
PO Box 3885470 Koloa Rd 2D
Koloa, HI 96756-0388
Phone (808) 742-2055
Other providers in Koloa, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.