Mr Michael A Dattola, LCSW | |
1090 E Kuiaha Rd, Haiku, HI 96708-5535 | |
(808) 707-7219 | |
(808) 649-2229 |
Full Name | Mr Michael A Dattola |
---|---|
Gender | Male |
Speciality | Social Worker - Clinical |
Location | 1090 E Kuiaha Rd, Haiku, Hawaii |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1366458291 | NPI | - | NPPES |
3420 | Other | HI | STATE OF HAWAII LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 3420 (Hawaii) | Primary |
Entity Name | Kaiser Foundation Health Plan Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1063515567 PECOS PAC ID: 1850205360 Enrollment ID: O20031119000948 |
Mailing Address | Practice Location Address |
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Mr Michael A Dattola, LCSW Po Box 791976, Paia, HI 96779-1976 Ph: (808) 707-7219 | Mr Michael A Dattola, LCSW 1090 E Kuiaha Rd, Haiku, HI 96708-5535 Ph: (808) 707-7219 |
Ms. Eileen Anne Lang, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 4181a Aliikoa Pl, Haiku, HI 96708 Phone: 808-268-3762 Fax: 808-242-1469 | |
Marilou Penner, MSW LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1111 Kaupakalua Rd, Haiku, HI 96708 Phone: 808-269-7411 | |
Bethany Jo Hicks, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 651 Kauhikoa Rd, Haiku, HI 96708 Phone: 970-214-7735 |