Provider Demographics
NPI:1861768459
Name:LIND, ANGELA JIMENO (MD)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:JIMENO
Last Name:LIND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75-5751 KUAKINI HWY STE 203
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-1753
Mailing Address - Country:US
Mailing Address - Phone:808-333-3600
Mailing Address - Fax:808-961-5167
Practice Address - Street 1:1178 KINOOLE ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-7206
Practice Address - Country:US
Practice Address - Phone:808-969-1427
Practice Address - Fax:808-961-4795
Is Sole Proprietor?:No
Enumeration Date:2012-03-28
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD20777208000000X
HIMD19201208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics