# MARIA CARIDAD ILAR-REVILLA COMMUNITY HEALTH CLINIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386944437
- **Authorized official:** DR. MARIA CARIDAD ILAR-REVILLA M.D. (OWNER)
- **Authorized official phone:** (808) 677-5832

## Contact information

- **Practice address:** 94-866 MOLOALO ST STE 1B, WAIPAHU, HI 96797-3354
- **Practice address phone:** (808) 677-5832
- **Practice address fax:** (808) 671-9109
- **Mailing address:** 94-866 MOLOALO ST STE 1B, WAIPAHU, HI 96797-3354
- **Mailing address phone:** (808) 677-5832
- **Mailing address fax:** (808) 671-9109

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 9394 | HI | Yes |

## Other

- **Enumeration date:** 10/22/2010
- **Last updated:** 10/15/2012