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General NPI Number Information
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NPI Number | 1982795118
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Entity Type | Individual
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Provider Name | CHARLES ANTHONY SOMA M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 30 E LIPOA ST UNIT 4106
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City | KIHEI
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State | HI
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Zip | 96753-5821
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Country | US
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Telephone | 808-242-0001
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Fax | 808-244-6746
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Provider Business Mailing Address
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Address Line | 30 E LIPOA ST UNIT 4106
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City | KIHEI
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State | HI
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Zip | 96753-5821
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Country | US
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Telephone | 808-242-0001
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Fax | 808-244-6746
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 20-2598134
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License Number State | HI
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