Healthcare Provider Details

I. General information

NPI: 1013443340
Provider Name (Legal Business Name): ROBIN MARTIN D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2017
Last Update Date: 08/08/2023
Certification Date: 08/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4211 WAIALAE AVE STE 208
HONOLULU HI
96816-5312
US

IV. Provider business mailing address

4211 WAIALAE AVE STE 208
HONOLULU HI
96816-5312
US

V. Phone/Fax

Practice location:
  • Phone: 831-331-7536
  • Fax: 808-732-6433
Mailing address:
  • Phone: 808-888-5228
  • Fax: 808-213-7292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberDOS-2161
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: