Healthcare Provider Details

I. General information

NPI: 1396799425
Provider Name (Legal Business Name): RAZVAN ILIE FNP, DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 KAPIOLANI BLVD STE 808
HONOLULU HI
96814-4404
US

IV. Provider business mailing address

2175 GOODSTONE WAY
ROSEVILLE CA
95747-8840
US

V. Phone/Fax

Practice location:
  • Phone: 808-600-1173
  • Fax:
Mailing address:
  • Phone: 808-600-1173
  • Fax: 916-581-8434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95002192
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC30043
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number777273
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: