Healthcare Provider Details

I. General information

NPI: 1841497344
Provider Name (Legal Business Name): BRUCE A. G. SOLL M.D., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 LUSITANA ST SUITE 704
HONOLULU HI
96813-2429
US

IV. Provider business mailing address

606 HUNAKAI ST
HONOLULU HI
96816-4910
US

V. Phone/Fax

Practice location:
  • Phone: 808-524-2100
  • Fax:
Mailing address:
  • Phone: 808-732-1972
  • Fax: 808-484-1309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number2211
License Number StateHI

VIII. Authorized Official

Name: DR. BRUCE A. G. SOLL
Title or Position: OWNER
Credential: M.D.
Phone: 808-732-1972