Healthcare Provider Details

I. General information

NPI: 1194223255
Provider Name (Legal Business Name): RICHARD PINNER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2018
Last Update Date: 09/02/2022
Certification Date: 09/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 E LIPOA ST UNIT 4102
KIHEI HI
96753-5821
US

IV. Provider business mailing address

30 E LIPOA ST UNIT 4102
KIHEI HI
96753-5821
US

V. Phone/Fax

Practice location:
  • Phone: 808-793-9394
  • Fax:
Mailing address:
  • Phone: 808-793-9394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number13591
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: