1063134591 NPI number — CHERIE-LYN A DELIMA LMT

Table of content: CHERIE-LYN A DELIMA LMT (NPI 1063134591)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063134591 NPI number — CHERIE-LYN A DELIMA LMT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DELIMA
Provider First Name:
CHERIE-LYN
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
APUYA
Provider Other First Name:
CHERIE-LYN
Provider Other Middle Name:
T
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1063134591
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/27/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
91-1217 KANEANA ST # 14D
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EWA BEACH
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96706-3786
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-285-2819
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
99-128 AIEA HEIGHTS DRIVE
Provider Second Line Business Practice Location Address:
#207
Provider Business Practice Location Address City Name:
ALEA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96701-3968
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-487-0487
Provider Business Practice Location Address Fax Number:
808-486-8674
Provider Enumeration Date:
09/12/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225700000X , with the licence number:  5249 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225700000X , with the licence number: MAT5249 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)