Provider Demographics
NPI:1568251593
Name:ADVANCE WOUND CARE HAWAII LLC
Entity type:Organization
Organization Name:ADVANCE WOUND CARE HAWAII LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:QUIJANO
Authorized Official - Last Name:PANGAN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:725-279-7950
Mailing Address - Street 1:92-6009 NEMO ST
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-2817
Mailing Address - Country:US
Mailing Address - Phone:725-279-7950
Mailing Address - Fax:
Practice Address - Street 1:92-6009 NEMO ST
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-2817
Practice Address - Country:US
Practice Address - Phone:725-279-7950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-05
Last Update Date:2025-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty