Provider Demographics
NPI:1013050525
Name:HALE LE'A MEDICINE LLC
Entity type:Organization
Organization Name:HALE LE'A MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:ROGOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-828-2885
Mailing Address - Street 1:2460 OKA ST
Mailing Address - Street 2:#101
Mailing Address - City:KILAUEA
Mailing Address - State:HI
Mailing Address - Zip Code:96754
Mailing Address - Country:US
Mailing Address - Phone:808-828-2885
Mailing Address - Fax:808-828-0119
Practice Address - Street 1:2460 OKA ST
Practice Address - Street 2:#101
Practice Address - City:KILAUEA
Practice Address - State:HI
Practice Address - Zip Code:96754
Practice Address - Country:US
Practice Address - Phone:808-828-2885
Practice Address - Fax:808-828-0119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAMD-67363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty