Charles a. Wilson D.O., LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DOS 1154 Issued in HI

Legal business name

CHARLES A. WILSON D.O., LLC

Practice address

91-2139 Fort Weaver Rd
Suite 213
Ewa Beach, HI 96706-3607

Phone

(808) 677-8008

Fax

(808) 677-8007

NPI assigned

Aug 11, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Charles Ashley Wilson, D.O.

Title

Sole Member

Phone

(808) 744-1906

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281484800000",
    "number": "1720393937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-2139 FORT WEAVER RD",
            "address_2": "SUITE 213",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967063607",
            "telephone_number": "808-677-8008",
            "fax_number": "808-677-8007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-2139 FORT WEAVER RD",
            "address_2": "SUITE 213",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967063607",
            "telephone_number": "808-677-8008",
            "fax_number": "808-677-8007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES A. WILSON D.O., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-11",
        "last_updated": "2010-08-11",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "ASHLEY",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "808-744-1906",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "DOS 1154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "597081",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly K Chan
• Anthony Ray Chance, MSW
• Willis Chang, M.D.
• Steven Lambert Chaplin, M.D.
• Julia Char
• Shivani Singh Chaudhary, MD
• Samson Chik
• Child and Family Service
• Child and Family Service
• Child and Family Service

• Family Medicine Physician in Ewa Beach, HI
• Providers in Ewa Beach, HI by specialty
• Family Medicine Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; 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.