Healthcare Provider Details

I. General information

NPI: 1215195680
Provider Name (Legal Business Name): CHRISSY ALLYN CAPATI D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2008
Last Update Date: 01/04/2023
Certification Date: 01/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1333 WAIANUENUE AVE
HILO HI
96720-1202
US

IV. Provider business mailing address

PO BOX 2153 DEPT 40339
BIRMINGHAM AL
35287-9387
US

V. Phone/Fax

Practice location:
  • Phone: 808-961-6644
  • Fax:
Mailing address:
  • Phone: 706-271-0100
  • Fax: 706-270-0487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDOS1315
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: