MEDICARE: RICHARD ROTHSCHILLER, PSY.D., LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY1034	HI

General Provider Information

NPI Number	:	1922508381
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD ROTHSCHILLER, PSY.D., LLC

Provider Business Mailing Address
First Line	:	3820 MONTEREY DR
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96816-3920
Country	:	US
Telephone Number	:	808-277-9159
Fax Number	:

Provider Business Practice Location Address
First Line	:	444 HOBRON LN
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96815-1231
Country	:	US
Telephone Number	:	808-277-9159
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RICHARD ROTHSCHILLER
Credential	:	PHD
Telephone Number	:	808-277-9159

Provider Enumeration Date	:	02/12/2018
Last Update Date	:	02/12/2018

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