Charlene Gaile Poderoso, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC-1394 Issued in HI

Practice address

94-1171 Polinahe PL
Waipahu, HI 96797

Phone

(650) 524-5644

NPI assigned

Jul 27, 2017

Last updated

May 31, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1501113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527724800000",
    "number": "1487178836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-1171 POLINAHE PL",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967974035",
            "telephone_number": "650-524-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-1171 POLINAHE PL",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "96797",
            "telephone_number": "650-524-5644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODEROSO",
        "first_name": "CHARLENE",
        "middle_name": "GAILE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-27",
        "last_updated": "2018-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "HI",
            "license": "DC-1394",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "33905",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Waipahu, HI
• Providers in Waipahu, HI by specialty
• Chiropractor in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.