Healthcare Provider Details

I. General information

NPI: 1760536759
Provider Name (Legal Business Name): MICHAEL J. MCGRATH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75-1091 KAMALANI ST
HOLUALOA HI
96725-9646
US

IV. Provider business mailing address

75-1091 KAMALANI STREET
HOLUALOA HI
96725-1719
US

V. Phone/Fax

Practice location:
  • Phone: 808-334-4400
  • Fax:
Mailing address:
  • Phone: 808-334-4400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD - 9172
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG75088
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: