| Rodrigo G. Bristol, M.d., Inc. | |
|
634 Kalihi St Honolulu HI 96819-4000 | |
| (808) 845-3911 | |
| (808) 848-0870 |
| Full Name | Rodrigo G. Bristol, M.d., Inc. |
|---|---|
| Speciality | General Practice |
| Location | 634 Kalihi St, Honolulu, Hawaii |
| Authorized Official Name and Position | Rodrigo Gose Bristol (PRESIDENT) |
| Authorized Official Contact | 8088453911 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rodrigo G. Bristol, M.d., Inc. 634 Kalihi St Honolulu HI 96819-4000 Ph: (808) 845-3911 | Rodrigo G. Bristol, M.d., Inc. 634 Kalihi St Honolulu HI 96819-4000 Ph: (808) 845-3911 |
| NPI Number | 1053625723 |
|---|---|
| Provider Enumeration Date | 08/04/2010 |
| Last Update Date | 08/04/2010 |
| Medicare PECOS PAC ID | 4284810094 |
|---|---|
| Medicare Enrollment ID | O20110512000055 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053625723 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 2213 (Hawaii) | Primary |
| Provider Name | Rodrigo G Bristol |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1811079924 PECOS PAC ID: 3274719083 Enrollment ID: I20110512000074 |
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