| Godofredo B. Baclig, M.d. Inc. | |
|
405 N Kuakini St Suite 1112 Honolulu HI 96817-6300 | |
| (808) 524-5024 | |
| (808) 524-5715 |
| Full Name | Godofredo B. Baclig, M.d. Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 405 N Kuakini St, Honolulu, Hawaii |
| Authorized Official Name and Position | Godofredo Baclig (PRESIDENT) |
| Authorized Official Contact | 8085245024 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Godofredo B. Baclig, M.d. Inc. 405 N Kuakini St Suite 1112 Honolulu HI 96817-6300 Ph: (808) 524-5024 | Godofredo B. Baclig, M.d. Inc. 405 N Kuakini St Suite 1112 Honolulu HI 96817-6300 Ph: (808) 524-5024 |
| NPI Number | 1609116904 |
|---|---|
| Provider Enumeration Date | 02/22/2013 |
| Last Update Date | 02/22/2013 |
| Medicare PECOS PAC ID | 2163677006 |
|---|---|
| Medicare Enrollment ID | O20130227000166 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609116904 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | MD-8967 (Hawaii) | Primary |
| Provider Name | Godofredo B Baclig |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114010709 PECOS PAC ID: 9335162551 Enrollment ID: I20060113000019 |
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