Provider Demographics
NPI:1386754257
Name:GENIO, DOMINADOR DIOKNO JR (MD)
Entity type:Individual
Prefix:DR
First Name:DOMINADOR
Middle Name:DIOKNO
Last Name:GENIO
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:75-5995 KUAKINI HWY
Mailing Address - Street 2:SUITE #427
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-2144
Mailing Address - Country:US
Mailing Address - Phone:808-329-3588
Mailing Address - Fax:808-329-3233
Practice Address - Street 1:75-5995 KUAKINI HWY
Practice Address - Street 2:SUITE #427
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-2144
Practice Address - Country:US
Practice Address - Phone:808-329-3588
Practice Address - Fax:808-329-3233
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
HI8532207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIB08394Medicare UPIN