Organization Name: | E MALAMA KAKOU FAMILY PRACTICE |
NPI Number: | 1770918757 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LYNDA HIRAKAMI (PRIMARY CARE PROVIDER) |
Mailing Address: | 153014 Pahoa Village Road Pahoa |
State: | HI US |
Postal Code: | 96778 |
Phone Number: | 8083397093 |
Fax Number: | 8083397076 |
NPI Enumeration Date: | 09/09/2013 |
NPI Last Update Date: | 04/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | 979 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | HI |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |