Wesley Hagio

Individual provider Active NPI Community Health Worker · Keaau, HI

NPI 1962051029 · NPPES record last updated Sep 10, 2019

Key facts

NPI
1962051029
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Worker 172V00000X
Practice address
16-204 Melekahiwa PL Ste 3
Keaau, HI 96749-8010
Phone
(612) 272-8724
NPI assigned
Sep 10, 2019
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Yes

Addresses

Primary practice location

16-204 Melekahiwa PL Ste 3
Keaau, HI 96749-8010

Mailing address

710 Green St
Honolulu, HI 96813-2119
Phone (808) 536-1015

Other identifiers

IdentifierTypeStateIssuer
172V00000XMedicaidHI

Other providers in Keaau, HI

All providers in Keaau, HI · Community Health Worker in Hawaii

Sources for this page

Verify at the official NPI Registry.