Healthcare Provider Details

I. General information

NPI: 1962316745
Provider Name (Legal Business Name): BRANDON TOMA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 FARRINGTON HWY UNIT 205
KAPOLEI HI
96707-2002
US

IV. Provider business mailing address

99-521 POHUE ST
AIEA HI
96701-3350
US

V. Phone/Fax

Practice location:
  • Phone: 808-425-7092
  • Fax:
Mailing address:
  • Phone: 808-203-9677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMAT-15118
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: