Healthcare Provider Details

I. General information

NPI: 1699899500
Provider Name (Legal Business Name): CURTIS BEKKUM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4950 UAKEA RD
HANA HI
96713-0278
US

IV. Provider business mailing address

PO BOX 278
HANA HI
96713-0278
US

V. Phone/Fax

Practice location:
  • Phone: 808-248-8840
  • Fax: 808-248-8839
Mailing address:
  • Phone: 808-248-8840
  • Fax: 808-248-8839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD17180
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: