Healthcare Provider Details

I. General information

NPI: 1528021862
Provider Name (Legal Business Name): JASON T CALL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2006
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 MAUI LANI PKWY
WAILUKU HI
96793-2416
US

IV. Provider business mailing address

85 MAUI LANI PKWY
WAILUKU HI
96793-2416
US

V. Phone/Fax

Practice location:
  • Phone: 808-442-5700
  • Fax: 855-827-2321
Mailing address:
  • Phone: 808-442-5700
  • Fax: 855-827-2321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number22033
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number0101237735
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number0101237735
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number22033
License Number StateWV
# 5
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number23299
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: