Healthcare Provider Details

I. General information

NPI: 1306874094
Provider Name (Legal Business Name): CALVIN C.M. KAM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PUNCHBOWL ST
HONOLULU HI
96813-2402
US

IV. Provider business mailing address

PO BOX 29640
HONOLULU HI
96820-2040
US

V. Phone/Fax

Practice location:
  • Phone: 808-538-9011
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberMD1370
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: