Healthcare Provider Details

I. General information

NPI: 1760327746
Provider Name (Legal Business Name): ROBERT BRADLEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 03/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1356 LUSITANA ST FL 4
HONOLULU HI
96813-2409
US

IV. Provider business mailing address

1356 LUSITANA ST FL 4
HONOLULU HI
96813-2409
US

V. Phone/Fax

Practice location:
  • Phone: 808-691-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMDR-9204
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: