Healthcare Provider Details

I. General information

NPI: 1912575903
Provider Name (Legal Business Name): LANDON KOZAI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2021
Last Update Date: 11/07/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 N KUAKINI ST
HONOLULU HI
96817-2306
US

IV. Provider business mailing address

PO BOX 12176
HONOLULU HI
96828-1176
US

V. Phone/Fax

Practice location:
  • Phone: 808-547-9274
  • Fax: 808-547-9547
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD-24480
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: