Healthcare Provider Details

I. General information

NPI: 1447375266
Provider Name (Legal Business Name): ERIC B RICHMOND C.R.N.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1319 PUNAHOU ST
HONOLULU HI
96826-1001
US

IV. Provider business mailing address

98-715 IHO PL BUILDING 4 APT 1501
AIEA HI
96701-2514
US

V. Phone/Fax

Practice location:
  • Phone: 808-986-8000
  • Fax:
Mailing address:
  • Phone: 808-484-0608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN786
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: