Healthcare Provider Details

I. General information

NPI: 1134048473
Provider Name (Legal Business Name): ISABEL MEDRANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1337 LOWER CAMPUS RD RM 231
HONOLULU HI
96822-2352
US

IV. Provider business mailing address

3532 HINAHINA ST
HONOLULU HI
96816-2817
US

V. Phone/Fax

Practice location:
  • Phone: 808-956-7606
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: