Provider Demographics
NPI:1184629669
Name:LINDBORG, C ERIC (MD)
Entity Type:Individual
Prefix:DR
First Name:C
Middle Name:ERIC
Last Name:LINDBORG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:CHARLES
Other - Middle Name:ERIC
Other - Last Name:LINDBORG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:75-5751 KUAKINI HWY STE 203
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-1753
Mailing Address - Country:US
Mailing Address - Phone:808-326-5629
Mailing Address - Fax:
Practice Address - Street 1:75-5751 KUAKINI HWY STE 101A
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-1705
Practice Address - Country:US
Practice Address - Phone:808-326-5629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI4851207P00000X, 207Q00000X
WA252-09207P00000X
IN01026295207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine