Provider Demographics
NPI:1013205624
Name:SUSAN M.S. CAULEY, M.D., INC.
Entity Type:Organization
Organization Name:SUSAN M.S. CAULEY, M.D., INC.
Other - Org Name:RAINBOW HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CAULEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-238-4922
Mailing Address - Street 1:43 E LANIKAULA ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-4301
Mailing Address - Country:US
Mailing Address - Phone:808-238-4922
Mailing Address - Fax:
Practice Address - Street 1:43 E LANIKAULA ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4301
Practice Address - Country:US
Practice Address - Phone:808-238-4922
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-16
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI8551261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI070982-04Medicaid
HIF7291Medicare UPIN