Doctor Name: | DOMINGO B. GUMPAL |
NPI Number: | 1124154356 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 1547 |
Business Practice Address: | 296 W Hawaii St Kahului, HI - 967322610 |
Business Phone Number: | 8088738802 |
Business Fax Number: | |
Mailing Address: | 296 W Hawaii St, KAHULUI |
State: | HI |
Postal Code: | 967322610 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 02/23/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 1547 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | HI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |