Healthcare Provider Details

I. General information

NPI: 1346585700
Provider Name (Legal Business Name): CHARINA K. O. TOILOLO PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHARINA SUMNER PA-C

II. Dates (important events)

Enumeration Date: 12/11/2012
Last Update Date: 05/07/2021
Certification Date: 05/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 PENSACOLA ST
HONOLULU HI
96814-2118
US

IV. Provider business mailing address

1010 PENSACOLA ST
HONOLULU HI
96814-2118
US

V. Phone/Fax

Practice location:
  • Phone: 808-432-2000
  • Fax:
Mailing address:
  • Phone: 808-432-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberAMD #482
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: