Provider Demographics
NPI:1760936363
Name:PALACIOS, CHRISTOPHER ADAM (PA-C, MSHS)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:ADAM
Last Name:PALACIOS
Suffix:
Gender:M
Credentials:PA-C, MSHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75-5995 KUAKINI HWY
Mailing Address - Street 2:STE 213
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-2120
Mailing Address - Country:US
Mailing Address - Phone:971-237-7486
Mailing Address - Fax:
Practice Address - Street 1:75-5995 KUAKINI HWY
Practice Address - Street 2:#213
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-2144
Practice Address - Country:US
Practice Address - Phone:808-365-2297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-11
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAMD-703363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical