Provider Demographics
NPI:1366550568
Name:CARDIOPULMONARY DIAGNOSTIC SERVICES INC
Entity type:Organization
Organization Name:CARDIOPULMONARY DIAGNOSTIC SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:REYNOLD
Authorized Official - Middle Name:L
Authorized Official - Last Name:MANABAT
Authorized Official - Suffix:
Authorized Official - Credentials:RRT CRTT
Authorized Official - Phone:808-678-1422
Mailing Address - Street 1:94-216 FARRINGTON HWY
Mailing Address - Street 2:STE B2106
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-1922
Mailing Address - Country:US
Mailing Address - Phone:808-678-1422
Mailing Address - Fax:808-678-0111
Practice Address - Street 1:94-216 FARRINGTON HWY
Practice Address - Street 2:STE B2106
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-1922
Practice Address - Country:US
Practice Address - Phone:808-678-1422
Practice Address - Fax:808-678-0111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI3112428OtherUHA
HI0230789OtherHMSA
HI50790701Medicaid
HI50790701Medicaid