Healthcare Provider Details

I. General information

NPI: 1427187335
Provider Name (Legal Business Name): WEST SHORE NEUROLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91-2139 FORT WEAVER RD STE 210
EWA BEACH HI
96706-3609
US

IV. Provider business mailing address

91-2139 FORT WEAVER RD STE 210
EWA BEACH HI
96706-3609
US

V. Phone/Fax

Practice location:
  • Phone: 808-680-0558
  • Fax:
Mailing address:
  • Phone: 808-680-0558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RAY R ROMERO
Title or Position: PRESIDENT
Credential: M.D
Phone: 808-680-0558