Healthcare Provider Details

I. General information

NPI: 1891852141
Provider Name (Legal Business Name): KUAKINI PATHOLOGLISTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 N KUAKINI ST
HONOLULU HI
96817-2336
US

IV. Provider business mailing address

347 N KUAKINI ST
HONOLULU HI
96817-2336
US

V. Phone/Fax

Practice location:
  • Phone: 808-547-9496
  • Fax: 808-547-9497
Mailing address:
  • Phone: 808-547-9496
  • Fax: 808-547-9497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. EUGENE TAKAJI YANAGIHARA
Title or Position: LAB DIRECTOR
Credential: M.D.
Phone: 808-547-9496