Provider Demographics
NPI:1689775629
Name:CASTRO, TANYA LIMTIACO
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:LIMTIACO
Last Name:CASTRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 KAIOLU ST
Mailing Address - Street 2:#301
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-2275
Mailing Address - Country:US
Mailing Address - Phone:808-489-6677
Mailing Address - Fax:808-737-4324
Practice Address - Street 1:3427 WAIALAE AVE
Practice Address - Street 2:SUITE C
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-2619
Practice Address - Country:US
Practice Address - Phone:808-737-5433
Practice Address - Fax:808-737-4324
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDC1042111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor