Healthcare Provider Details

I. General information

NPI: 1174605877
Provider Name (Legal Business Name): CHRISTOPHER ANTHONY TAYLOR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 02/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 ULUNIU ST SUITE 201
KAILUA HI
96734-2519
US

IV. Provider business mailing address

88 MAKAWELI ST
HONOLULU HI
96825-2147
US

V. Phone/Fax

Practice location:
  • Phone: 808-261-7246
  • Fax: 808-261-7248
Mailing address:
  • Phone: 808-234-4940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number14322
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number14322
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberMD-14322
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: