Provider Demographics
NPI:1548419005
Name:ROBERT V JAO MD INC A HAWAII CORPORATION
Entity Type:Organization
Organization Name:ROBERT V JAO MD INC A HAWAII CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:V
Authorized Official - Last Name:JAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-263-4665
Mailing Address - Street 1:642 ULUKAHIKI ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4400
Mailing Address - Country:US
Mailing Address - Phone:808-263-4665
Mailing Address - Fax:808-263-4718
Practice Address - Street 1:407 ULUNIU ST STE 113
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2531
Practice Address - Country:US
Practice Address - Phone:088-263-4665
Practice Address - Fax:808-263-4718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-09
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD9896174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00232801Medicaid
HIG57692Medicare UPIN
HIH50484Medicare PIN