1184758278 NPI number — DR. ROBERT LEY INC.

Table of content: (NPI 1184758278)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184758278 NPI number — DR. ROBERT LEY INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR. ROBERT LEY INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184758278
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
208 KAMAKOI LOOP
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KIHEI
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96753-7122
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-875-7595
Provider Business Mailing Address Fax Number:
808-875-1173

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1819 S KIHEI RD
Provider Second Line Business Practice Location Address:
SUITE D-101
Provider Business Practice Location Address City Name:
KIHEI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96753-7941
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-875-7595
Provider Business Practice Location Address Fax Number:
808-875-1173
Provider Enumeration Date:
03/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LEY
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
C
Authorized Official Title or Position:
REGISTERED AGENT
Authorized Official Telephone Number:
808-875-7595

Provider Taxonomy Codes

  • Taxonomy code: 302R00000X , with the licence number:  DOS526 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: DOS526 . This is a "HI MEDICAL LICENSE" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com