Provider Demographics
NPI:1508878497
Name:RICALDE-GARCIA, ARLEEN ATIENZA (MD)
Entity Type:Individual
Prefix:DR
First Name:ARLEEN
Middle Name:ATIENZA
Last Name:RICALDE-GARCIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 MAHALANI ST RM 4
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-2521
Mailing Address - Country:US
Mailing Address - Phone:808-442-6856
Mailing Address - Fax:808-249-0107
Practice Address - Street 1:95 MAHALANI ST RM 4
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-2521
Practice Address - Country:US
Practice Address - Phone:808-442-6856
Practice Address - Fax:808-249-0107
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD9947207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIMD9947OtherTRICARE CHAMPUS
HI218552OtherHMSA, HMSA QUEST, 65CP
HI867543OtherUHA
HIH52159Medicare PIN
HIMD9947OtherTRICARE CHAMPUS