Provider Demographics
NPI:1215193867
Name:LLOYD, GARY (CSAC)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:
Last Name:LLOYD
Suffix:
Gender:M
Credentials:CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:758 KAPAHULU AVENUE
Mailing Address - Street 2:WAIKIKI HEALTH CENTER
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-1196
Mailing Address - Country:US
Mailing Address - Phone:808-791-9333
Mailing Address - Fax:808-791-9314
Practice Address - Street 1:1640 S KING STREET
Practice Address - Street 2:WAIKIKI HEALTH CENTER CARE A VAN
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826
Practice Address - Country:US
Practice Address - Phone:808-922-4790
Practice Address - Fax:808-922-4780
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1280-09101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)