Provider Demographics
NPI:1578649588
Name:HOUSECALLS OF HAWAII LLC
Entity Type:Organization
Organization Name:HOUSECALLS OF HAWAII LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:GELIGA
Authorized Official - Suffix:
Authorized Official - Credentials:PAC
Authorized Official - Phone:808-987-3516
Mailing Address - Street 1:PO BOX 4327
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96745-4327
Mailing Address - Country:US
Mailing Address - Phone:808-987-3516
Mailing Address - Fax:808-329-9082
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:808-987-3516
Practice Address - Fax:808-329-9082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAMD-191363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIP62185Medicare UPIN