Individual
WARREN B SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3791 LOHE RD, KALAHEO, HI 96741-9614
(541) 602-0306
(541) 610-1647
Mailing address
3791 LOHE RD, KALAHEO, HI 96741-9614
(541) 602-0306
(541) 610-1647
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4105
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
055542000
BCBS
—
05
—
057237
—
OR
01
—
56097
L & I
WA
05
—
8351561
—
WA
01
—
8936785
CRIME VICTIMS
—
01
—
C98636
GROUP HEALTH
—
01
—
JM9441
PACC
—
05
—
XPY186579
—
CA
Enumeration date
06/28/2006
Last updated
08/06/2019
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