Provider Demographics
NPI:1952885261
Name:PILIKIAN, TIA (PA-C)
Entity Type:Individual
Prefix:
First Name:TIA
Middle Name:
Last Name:PILIKIAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1830 WELLS ST STE 101
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-2365
Mailing Address - Country:US
Mailing Address - Phone:808-856-4060
Mailing Address - Fax:808-442-9670
Practice Address - Street 1:1830 WELLS ST STE 101
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-2365
Practice Address - Country:US
Practice Address - Phone:808-856-4060
Practice Address - Fax:808-442-9670
Is Sole Proprietor?:No
Enumeration Date:2018-09-21
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIAMD-987363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant