PANIOLO PEDIATRICS LLC NPI 1790162980

NPI Information

NPI: 1790162980
Provider Name: PANIOLO PEDIATRICS LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 12D2165270

Address:
64-1032 MAMALAHOA HWY STE 204
KAMUELA, HI
ZIP 96743
Phone: (808) 887-6543
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PANIOLO PEDIATRICS LLC is a primary care clinic center in Kamuela, HI. PANIOLO PEDIATRICS LLC NPI is 1790162980. The provider is registered as an organization entity type.

The provider's business location address is:

64-1032 MAMALAHOA HWY STE 204
KAMUELA, HI
ZIP 96743-441
Phone: (808) 887-6543
Fax: (808) 887-6294

The provider's authorized official is Brett Colin Ferguson .
The authorized official title is Sole Member and has the following contact phone number (808) 887-6543.

The CLIA number assigned to this NPI record is 12D2165270 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/27/2015 and was last updated on 4/27/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	MD16732	HAWAII	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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