Provider Demographics
NPI:1245652783
Name:CARMELITA D. CASIL
Entity type:Organization
Organization Name:CARMELITA D. CASIL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARMELITA
Authorized Official - Middle Name:DAGUIO
Authorized Official - Last Name:CASIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-671-0756
Mailing Address - Street 1:94-1020 HAPAPA ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-3735
Mailing Address - Country:US
Mailing Address - Phone:808-671-0756
Mailing Address - Fax:808-671-0756
Practice Address - Street 1:94-1020 HAPAPA ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3735
Practice Address - Country:US
Practice Address - Phone:808-671-0756
Practice Address - Fax:808-671-0756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-17
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3104A0625X302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization