Healthcare Provider Details

I. General information

NPI: 1891139085
Provider Name (Legal Business Name): SARAH LENORE GARCIA D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2013
Last Update Date: 05/19/2022
Certification Date: 05/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1190 WAIANUENUE AVE
HILO HI
96720-2094
US

IV. Provider business mailing address

1190 WAIANUENUE AVE
HILO HI
96720-2094
US

V. Phone/Fax

Practice location:
  • Phone: 808-932-3878
  • Fax:
Mailing address:
  • Phone: 808-932-3878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDOS-2159
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: