Provider Demographics
NPI:1184758278
Name:DR. ROBERT LEY INC.
Entity type:Organization
Organization Name:DR. ROBERT LEY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:LEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:808-875-7595
Mailing Address - Street 1:208 KAMAKOI LOOP
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-7122
Mailing Address - Country:US
Mailing Address - Phone:808-875-7595
Mailing Address - Fax:808-875-1173
Practice Address - Street 1:1819 S KIHEI RD
Practice Address - Street 2:SUITE D-101
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-7941
Practice Address - Country:US
Practice Address - Phone:808-875-7595
Practice Address - Fax:808-875-1173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDOS526302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIDOS526OtherHI MEDICAL LICENSE
HIDOS526OtherHI MEDICAL LICENSE