1386983153 NPI number — DR. TILDEN-CHRISTEN MICHAEL MIGUEL PHARMD

Table of content: DR. TILDEN-CHRISTEN MICHAEL MIGUEL PHARMD (NPI 1386983153)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386983153 NPI number — DR. TILDEN-CHRISTEN MICHAEL MIGUEL PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MIGUEL
Provider First Name:
TILDEN-CHRISTEN
Provider Middle Name:
MICHAEL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
M

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:
1386983153
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/18/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
01/09/2018
NPI Reactivation Date:
09/15/2022

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
670 PONAHAWAI STREET
Provider Second Line Business Mailing Address:
STE 211
Provider Business Mailing Address City Name:
HILO
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96720
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-865-0505
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
670 PONAHAWAI STREET
Provider Second Line Business Practice Location Address:
STE 211
Provider Business Practice Location Address City Name:
HILO
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-865-0505
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/13/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  PH-3429 , 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)





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