Provider Demographics
NPI:1508804584
Name:GELIGA, DARREN S (PA-C)
Entity Type:Individual
Prefix:
First Name:DARREN
Middle Name:S
Last Name:GELIGA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75-170 HUALALAI RD
Mailing Address - Street 2:STE C110
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-1780
Mailing Address - Country:US
Mailing Address - Phone:808-329-9211
Mailing Address - Fax:808-329-0009
Practice Address - Street 1:75-6107 HOOMAMA ST
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-7953
Practice Address - Country:US
Practice Address - Phone:808-329-9082
Practice Address - Fax:808-329-9082
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1052842363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00G0235270OtherHMSA
HI55623507Medicaid
HI55623507Medicaid