Provider Demographics
NPI:1437118304
Name:BAUM, FRANK RICHARD (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:RICHARD
Last Name:BAUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 KALEPA PL
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-2471
Mailing Address - Country:US
Mailing Address - Phone:808-871-7116
Mailing Address - Fax:808-877-4134
Practice Address - Street 1:200 KALEPA PL
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-2471
Practice Address - Country:US
Practice Address - Phone:808-871-7116
Practice Address - Fax:808-877-4134
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-5260208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI018600-01OtherALOHACARE QUEST
HI1860001Medicaid
HID36277Medicare UPIN