Provider Demographics
NPI:1306241997
Name:DELANGEN, DAISY (LAC)
Entity type:Individual
Prefix:
First Name:DAISY
Middle Name:
Last Name:DELANGEN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73-1112 LOLOA DR # B
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-9497
Mailing Address - Country:US
Mailing Address - Phone:808-747-9266
Mailing Address - Fax:
Practice Address - Street 1:75-5706 KUAKINI HWY STE 105
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-1751
Practice Address - Country:US
Practice Address - Phone:808-747-9266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-26
Last Update Date:2014-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIACU1107171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist