Healthcare Provider Details

I. General information

NPI: 1972623940
Provider Name (Legal Business Name): WILLIAMKKLAU, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 LUSITANA ST SUITE 305
HONOLULU HI
96813-2429
US

IV. Provider business mailing address

1329 LUSITANA ST SUITE 305
HONOLULU HI
96813-2429
US

V. Phone/Fax

Practice location:
  • Phone: 808-532-2955
  • Fax: 808-532-2960
Mailing address:
  • Phone: 808-532-2955
  • Fax: 808-532-2960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberMD02629
License Number StateHI

VIII. Authorized Official

Name: DR. WILLIAM KIENKI LAU
Title or Position: PRESIDENT
Credential: M.D.
Phone: 808-532-2955