Healthcare Provider Details

I. General information

NPI: 1013972603
Provider Name (Legal Business Name): UROLOGY CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 06/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 LUSITANA STREET SUITE #1004
HONOLULU HI
96813-2449
US

IV. Provider business mailing address

1380 LUSITANA STREET SUITE #1004
HONOLULU HI
96813-2449
US

V. Phone/Fax

Practice location:
  • Phone: 808-523-9400
  • Fax: 808-526-3080
Mailing address:
  • Phone: 808-523-9400
  • Fax: 808-526-3080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT G. CARLILE
Title or Position: OWNER
Credential: M.D.
Phone: 808-523-9400