Blake, Randall Charles

Blake, Randall Charles is an sole proprietor health care provider with primary practice located at 1329 Lusitana St Suite 602, Honolulu HI 96813-2429. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Blake, Randall Charles can be contacted via phone (808) 522-5055.

Contact Information

Primary practice address
1329 Lusitana St Suite 602 Honolulu HI 96813-2429
Phone: (808) 522-5055
Fax: (808) 524-6306
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 14192 Hawaii

Profile Details

NPI number 1447226055
LBN Legal business name Blake, Randall Charles
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 23rd, 2006
Last updated Jun 28th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447226055 NPPES
Indiana MEDICAID 100171930A

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