CARLOS BOLIVAR PANCHANA (NPI# 1881226637) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881226637 |
| Entity Type | Individual |
| Full Name | CARLOS BOLIVAR PANCHANA |
| Practice Address |
D St #3089 Kailua HI 96734 |
| Mailing Address |
10345 Holder Way San Diego CA 92124-2512 |
| Practice Telephone | 3218907187 |
| Mailing Telephone | 3218907187 |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2020-02-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
CA | Other Service Providers |
| Street Address |
D ST #3089 |
| City | KAILUA |
| State | HI |
| Zip Code | 96734 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811401862 | Pamela Carr | Registered Nurse | D St #3089, Kailua, HI 96734 | 2017-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144828773 | About Face Kailua, LLC | General Practice | 970 N. Kalahea Ave, Suite A-11, Kailua, HI 96734 | 2020-10-15 |
| 1134726979 | Sara Eller | Radiology | Building 6905 Mcbh, Pearl Harbor, HI 96734 | 2020-10-05 |
| 1205441888 | William Andrew Fitzpatrick | Military Health Care Provider | Bldg 6905, Mcbh, HI 96734 | 2020-09-10 |
| 1215549670 | Joseph Frabotta | Military Health Care Provider | 6894r Mokapu Rd, Kailua, HI 96734 | 2020-08-18 |
| 1437776366 | Amanda Lindsay Krasniewski | Behavior Technician | 203 Kapaa Quarry Place, Suite #5002, Kailua, HI 96734 | 2020-06-26 |
| 1760007108 | Yoli Gabrielle Teran | Behavior Technician | 203 Kapaa Quarry Pi #5002, Kailua, HI 96734 | 2020-06-11 |
| 1902427206 | Amberlie Remily | Behavior Technician | 203 Kapaa Quarry Pl. #5002, Kailua, HI 96734 | 2020-04-28 |
| 1417586264 | Jennifer Eng | Marriage & Family Therapist | 6842 Harris Ave, Kailua, HI 96734 | 2020-04-03 |
| 1023644523 | Roxan Mae Sardido Okamoto | Specialist | 1178 Lunahana Place, Kailua, HI 96734 | 2020-03-16 |
| 1811520240 | Sherly Macion | Registered Nurse | 720 A1 Kihapai Place, Kailua, HI 96734 | 2020-02-13 |
| Find all providers in zip 96734 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215549670 | Joseph Frabotta | Military Health Care Provider | 6894r Mokapu Rd, Kailua, HI 96734 | 2020-08-18 |
| 1508484882 | David Jason Brown | Military Health Care Provider | 6255 Kaawa St, Kailua, HI 96734-4984 | 2020-07-13 |
| 1811363120 | Timothy Layton | Military Health Care Provider | 1016 Ulupau Loop, Kailua, HI 96734-4772 | 2015-08-20 |
| 1902249436 | Alex Joseph Valencia | Military Health Care Provider | 3005 Glen Cove, Kailua, HI 96734-3004 | 2013-04-15 |
| 1588849442 | Conrado Obias Manganti Jr. | Military Health Care Provider | 2073b Campion Dr, Kailua, HI 96734-4818 | 2008-01-09 |
| 1801077466 | Jeffrey Douglas Fisher | Military Health Care Provider | 2709 Apt A, Cushman Ave, Kailua, HI 96734 | 2007-11-23 |
| 1629269949 | Mark Alan Schuchard | Military Health Care Provider | 4182 Hamehame St, Kailua, HI 96734-6824 | 2007-08-05 |
| 1447345855 | Craig William Meaders | Military Health Care Provider | 2618 A Bordelone Lp, Kailua, HI 96734 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205441888 | William Andrew Fitzpatrick | Military Health Care Provider | Bldg 6905, Mcbh, HI 96734 | 2020-09-10 |
| 1134759715 | David Maldonado Santiago | Military Health Care Provider | 590 Moffet St, Jbphh, HI 96853-5168 | 2020-01-22 |
| 1003325366 | Justin Hesse | Military Health Care Provider | Building 17 Bishop Point, Pearl Harbor, HI 96860 | 2017-09-29 |
| 1649796244 | Joshua I White | Military Health Care Provider | Bldg 4078 Harris Rd., Mcbh Kaneohe Bay, HI 96863 | 2017-08-16 |
| 1104290519 | Carlton Jacob Maughan | Military Health Care Provider | Bldg 17 Bishops Point, Pearl Harbor, HI 96860 | 2015-11-23 |
| 1700263001 | Daniel Joseph Engelhardt | Military Health Care Provider | 5435 Kilmer Ln, Honolulu, HI 96818-3467 | 2015-05-06 |
| 1316350168 | Bryan Goodman | Military Health Care Provider | Bldg #1058, Mcbh Kaneohe Bay, HI 96863 | 2014-06-10 |
| 1174966931 | Darrius Anthrawe Cooley | Military Health Care Provider | 5613 Bennion Ct, Honolulu, HI 96818-3224 | 2013-04-11 |
| 1922349968 | Jose Israel Lopez | Military Health Care Provider | Mdsu-1 Bishop Point, Building 17, Pearl Harbor, HI 96860 | 2013-03-14 |
| 1518201953 | Michael Keonisabino Aperto-apodaca | Military Health Care Provider | 6844 Ormoc St, Wahiawa, HI 96786-3048 | 2012-11-26 |
| Find all providers with the same taxonomy | ||||
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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.