Healthcare Provider Details

I. General information

NPI: 1922341486
Provider Name (Legal Business Name): CARLI BULLIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2013
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1319 PUNAHOU ST STE 600
HONOLULU HI
96826-1044
US

IV. Provider business mailing address

1319 PUNAHOU ST STE 600
HONOLULU HI
96826-1044
US

V. Phone/Fax

Practice location:
  • Phone: 808-522-4476
  • Fax:
Mailing address:
  • Phone: 808-522-4476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberA169013
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberMD-22027
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: