Healthcare Provider Details

I. General information

NPI: 1265484588
Provider Name (Legal Business Name): KA WAI TAM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 KAPIOLANI BLVD STE 2000
HONOLULU HI
96814-4408
US

IV. Provider business mailing address

766 ELEPAIO ST
HONOLULU HI
96816-4710
US

V. Phone/Fax

Practice location:
  • Phone: 808-947-5555
  • Fax: 808-481-0900
Mailing address:
  • Phone: 808-947-5555
  • Fax: 808-481-0900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD-25650
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: