Healthcare Provider Details

I. General information

NPI: 1588248637
Provider Name (Legal Business Name): ROBIN E CHAR PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2021
Last Update Date: 11/10/2022
Certification Date: 11/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64-1035 MAMALAHOA HWY STE F
KAMUELA HI
96743-8440
US

IV. Provider business mailing address

PO BOX 818
KAMUELA HI
96743-0818
US

V. Phone/Fax

Practice location:
  • Phone: 808-885-5900
  • Fax: 808-885-6900
Mailing address:
  • Phone: 808-753-7095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberAMD-1198
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: