Healthcare Provider Details

I. General information

NPI: 1730042359
Provider Name (Legal Business Name): ERIC RAYMOND LEON DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 S KING ST STE 307
HONOLULU HI
96814-2008
US

IV. Provider business mailing address

61-270 KAMEHAMEHA HWY APT A
HALEIWA HI
96712-1313
US

V. Phone/Fax

Practice location:
  • Phone: 808-809-8057
  • Fax:
Mailing address:
  • Phone: 808-864-1658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6285
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: