Basic Information
| Provider Information | |||||||||
| NPI: | 1053388769 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RINALDI WELDON | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 92-1246 KALEO PL | ||||||||
| Address2: | |||||||||
| City: | KAPOLEI | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967071535 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8086727246 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 94-235 HANAWAI CIR | ||||||||
| Address2: | SUITE 1B | ||||||||
| City: | WAIPAHU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967973029 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8086710090 | ||||||||
| FaxNumber: | 8086715376 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/01/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | AMD-224 | HI | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | 363AM0700X | PA14515 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.