Healthcare Provider Details

I. General information

NPI: 1699596049
Provider Name (Legal Business Name): GILLIAN A HIGA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2024
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99-115 AIEA HEIGHTS DR STE 246
AIEA HI
96701-3914
US

IV. Provider business mailing address

30658 GANADO DR
RANCHO PALOS VERDES CA
90275-6223
US

V. Phone/Fax

Practice location:
  • Phone: 808-784-3050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95031023
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: