Provider Demographics
NPI:1114565397
Name:CARPIO, RANDALL JAMES JR
Entity Type:Individual
Prefix:
First Name:RANDALL
Middle Name:JAMES
Last Name:CARPIO
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 932
Mailing Address - Street 2:
Mailing Address - City:KAPAAU
Mailing Address - State:HI
Mailing Address - Zip Code:96755-0932
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:56-793 KUALAPA PL
Practice Address - Street 2:
Practice Address - City:HAWI
Practice Address - State:HI
Practice Address - Zip Code:96719
Practice Address - Country:US
Practice Address - Phone:808-283-5576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-18
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI311175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty