Provider Demographics
NPI:1588960967
Name:WHANG, CRAIG
Entity type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:
Last Name:WHANG
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:CRAIG
Other - Middle Name:
Other - Last Name:WHANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1050 BISHOP ST # 515
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-4210
Mailing Address - Country:US
Mailing Address - Phone:808-554-4011
Mailing Address - Fax:
Practice Address - Street 1:1481 S KING ST STE 339
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2604
Practice Address - Country:US
Practice Address - Phone:808-554-4011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-02
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILMT 12071225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist