Healthcare Provider Details

I. General information

NPI: 1801892039
Provider Name (Legal Business Name): ROLAND C K NG MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 N KUAKINI ST STE 407
HONOLULU HI
96817-2360
US

IV. Provider business mailing address

321 N KUAKINI ST STE 407
HONOLULU HI
96817-2360
US

V. Phone/Fax

Practice location:
  • Phone: 808-521-1818
  • Fax: 808-537-1480
Mailing address:
  • Phone: 808-521-1818
  • Fax: 808-537-1480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD-4460
License Number StateHI

VIII. Authorized Official

Name: ROLAND CK NG
Title or Position: PRESIDENT
Credential: MD
Phone: 808-521-1818