DR. MARVIN PERRY MATLOCK (NPI# 1740245067) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740245067 |
| Entity Type | Individual |
| Full Name | DR. MARVIN PERRY MATLOCK |
| Credential | M.D. |
| Practice Address |
30 Oki Place Kaunakakai HI 96748 |
| Mailing Address |
Po Box 2040 Kaunakakai HI 96748-2040 |
| Practice Telephone | 8085535038 |
| Practice Fax Number | 8085533780 |
| Mailing Telephone | 8085535038 |
| Mailing Fax Number | 8085533780 |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2016-03-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | MD17722 | HI | Other Service Providers |
| N | 174400000X | Specialist | G30634 | CA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G306340 | 05 |
| Street Address |
30 OKI PLACE |
| City | KAUNAKAKAI |
| State | HI |
| Zip Code | 96748 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770570780 | Molokai Ohana Health Care, Inc. | Clinic/Center | 30 Oki Place, Kaunakakai, HI 96748-2040 | 2005-10-04 |
| 1992275861 | Adam R Long | Dentist | 30 Oki Place, Kaunakakai, HI 96748 | 2018-12-04 |
| 1457883209 | Dara Pagaduan | Nurse Practitioner | 30 Oki Place, Kaunakakai, HI 96748 | 2017-03-31 |
| 1164813184 | Ty Joo Mccomas | Nurse Practitioner | 30 Oki Place, Kaunakakai, HI 96748 | 2015-02-12 |
| 1154678621 | Mohc-ikaika | Early Intervention Provider Agency | 30 Oki Place, Kaunakakai, HI 96748 | 2012-08-14 |
| 1780786467 | Ronald Stephen Bloy | Dentist | 30 Oki Place, Kaunakakai, HI 96748-9674 | 2006-09-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265056154 | Molokai Physical Therapy & Rehabilitation LLC | Clinic/Center | 109 Ala Malama St Unit A, Kaunakakai, HI 96748 | 2020-06-05 |
| 1053953612 | Natalie Luczon | Massage Therapist | 30 Oki Pl, Kaunakakai, HI 96748 | 2019-10-15 |
| 1346753712 | Hawaii Life Flight, LLC | Ambulance | 317 Ilio Road, Kaunakakai, HI 96748 | 2017-11-08 |
| 1285008565 | Dino Akai | Nurse Practitioner | 30 Oki Pl., Kaunakakai, HI 96748 | 2015-11-24 |
| 1730567181 | Pakolea Rehab | Residential Treatment Facility, Physical Disabilities | 2 Kamoi St, Suite 300, Kaunakakai, HI 96748 | 2015-05-18 |
| 1366843740 | Dean K Chow | Chiropractor | 101 Ala Malama St Ste 103, Kaunakakai, HI 96748 | 2014-09-04 |
| 1427491448 | Genevieve F Correa | Physical Therapist | 93 Ala Malama Ave, Building B Unit A, Kaunakakai, HI 96748 | 2013-04-09 |
| 1679800882 | Ka Hale Pomaika'i | Community/Behavioral Health | Hc-01 Box 372 Kamehameha V Hwy, Ualapu'e, HI 96748 | 2009-11-09 |
| 1811222854 | Chris K Chow Dds Inc | Dentist | 15 Kaunakakai Pl, Suite 6, Kaunakakai, HI 96748 | 2009-10-08 |
| 1669605598 | Hale Ho'okupa'a | Community/Behavioral Health | 450 Ala Malama Avenue, Kaunakakai, HI 96748 | 2009-08-26 |
| Find all providers in zip 96748 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376143552 | Roman Queja | Specialist | 58 E Kauai St, Kahului, HI 96732-2940 | 2020-10-28 |
| 1285242974 | Norma Tomas Ragasa | Specialist | 156 Kealohilani St, Kahului, HI 96732-3128 | 2020-07-19 |
| 1821619156 | Resurreccion Bumanglag Buan | Specialist | 91-1044 Uouoa St, Ewa Beach, HI 96706-3593 | 2020-04-28 |
| 1558998872 | Erlinda D Ortal | Specialist | 91-1060 Hamana St, Ewa Beach, HI 96706-3938 | 2020-03-25 |
| 1023644523 | Roxan Mae Sardido Okamoto | Specialist | 1178 Lunahana Place, Kailua, HI 96734 | 2020-03-16 |
| 1386276384 | Deborah Lynn Koehn | Specialist | 41 Hookena Beach Road, Honaunau, HI 96726 | 2020-02-07 |
| 1669025623 | Armando Erfe Biacan | Specialist | 94-565 Loaa St, Waipahu, HI 96797-1511 | 2019-07-18 |
| 1801351002 | Maria Pola Tabladillo | Specialist | 94-483 Opeha St, Waipahu, HI 96797-4517 | 2019-02-01 |
| 1518403195 | Connie Kwan | Specialist | 94 689 Farrington Hwy, Waipahu, HI 96797-3015 | 2017-01-06 |
| 1760925960 | Brandon Allen Greene | Specialist | 1281 S King St, Honolulu, HI 96814-2254 | 2016-11-21 |
| Find all providers with the same taxonomy | ||||
| City | KAUNAKAKAI |
| Zip Code | 96748 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.