MEDICARE: SOLACE PSYCHIATRY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician
2	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1639034762
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOLACE PSYCHIATRY

Provider Business Mailing Address
First Line	:	438 HOBRON LN PH 1
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96815-1238
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	438 HOBRON LN PH 1
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96815-1238
Country	:	US
Telephone Number	:	916-572-6553
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AHMAD BILALL STANACKZAI
Credential	:	MD
Telephone Number	:	916-479-4393

Provider Enumeration Date	:	12/20/2025
Last Update Date	:	12/20/2025

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Directions to “SOLACE PSYCHIATRY ” Practice Location

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