Healthcare Provider Details
I. General information
NPI: 1790616308
Provider Name (Legal Business Name): BRAD THOMAS BYERLE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4569 KUKUI ST STE 201
KAPAA HI
96746-1775
US
IV. Provider business mailing address
PO BOX 296
KILAUEA HI
96754-0296
US
V. Phone/Fax
- Phone: 808-635-2242
- Fax:
- Phone: 808-635-2242
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | ACU-1474 |
| License Number State | HI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: