Basic Information
| Provider Information | |||||||||
| NPI: | 1336242791 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COLLORI | ||||||||
| FirstName: | PETER | ||||||||
| MiddleName: | G | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6600 KALANIANAOLE HWY | ||||||||
| Address2: | #225 | ||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968251281 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8083942800 | ||||||||
| FaxNumber: | 8083942826 | ||||||||
| Practice Location | |||||||||
| Address1: | 6600 KALANIANAOLE HWY | ||||||||
| Address2: | #225 | ||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968251281 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8083942800 | ||||||||
| FaxNumber: | 8083942826 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/07/2006 | ||||||||
| LastUpdateDate: | 04/17/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | MD1356 | HI | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | MD1356 | 01 | HI | QHCP | OTHER |