Provider Demographics
NPI:1518063197
Name:LAMPITOC, PERLITA BOLOSAN (MD)
Entity Type:Individual
Prefix:
First Name:PERLITA
Middle Name:BOLOSAN
Last Name:LAMPITOC
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 1:94-235 HANAWAI CIR
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-3029
Mailing Address - Country:US
Mailing Address - Phone:808-671-8539
Mailing Address - Fax:808-671-1681
Practice Address - Street 1:94-235 HANAWAI CIR
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3029
Practice Address - Country:US
Practice Address - Phone:808-671-8539
Practice Address - Fax:808-671-1681
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI50202080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI192497OtherHMA INC
HI01603701Medicaid
HI01719-4OtherHMSA
HI192497OtherHMA INC
HI01603701Medicaid