Healthcare Provider Details

I. General information

NPI: 1356536213
Provider Name (Legal Business Name): LISA N.L. KAHIKINA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2007
Last Update Date: 11/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1319 PUNAHOU ST
HONOLULU HI
96826-1001
US

IV. Provider business mailing address

3334 HOOLULU ST
HONOLULU HI
96815-3841
US

V. Phone/Fax

Practice location:
  • Phone: 808-983-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number14942
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: