Doctor Name: | KAANOHIOKALA PEA |
NPI Number: | 1689085151 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMT |
License Number: | MAT-9551 |
Business Practice Address: | 17-211 Palaai St Keaau, HI - 967498213 |
Business Phone Number: | 8083337890 |
Business Fax Number: | |
Mailing Address: | 17-211 Palaai St, KEAAU |
State: | HI |
Postal Code: | 967498213 |
Phone Number: | 8083337890 |
Fax Number: | |
NPI Enumeration Date: | 05/18/2014 |
NPI Last Update Date: | 05/18/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MAT-9551 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | HI |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |