Healthcare Provider Details

I. General information

NPI: 1376635268
Provider Name (Legal Business Name): MARIA STELLA KALALO BATOL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIA-STELLA KALALO PERLAS MD

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 10/11/2023
Certification Date: 10/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65-1190 MAMALAHOA HWY
KAMUELA HI
96743-8431
US

IV. Provider business mailing address

45-549 PLUMERIA ST
HONOKAA HI
96727-6902
US

V. Phone/Fax

Practice location:
  • Phone: 808-855-4488
  • Fax: 808-885-4126
Mailing address:
  • Phone: 808-885-5448
  • Fax: 808-885-4126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number10527
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: