Healthcare Provider Details

I. General information

NPI: 1770490740
Provider Name (Legal Business Name): KAIWA WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 ACHO TASI ST
TAMUNING GU
96913-3116
US

IV. Provider business mailing address

285 FARENHOLT AVE STE 303 PMB 1941
TAMUNING GU
96913
US

V. Phone/Fax

Practice location:
  • Phone: 671-480-5034
  • Fax:
Mailing address:
  • Phone: 671-480-5034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. MEGUMI HOMMA
Title or Position: OWNER/CHIROPRACTOR
Credential: D.C.
Phone: 671-480-5034