Healthcare Provider Details

I. General information

NPI: 1669138707
Provider Name (Legal Business Name): KUAKINI MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2021
Last Update Date: 11/12/2021
Certification Date: 11/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 N KUAKINI ST
HONOLULU HI
96817-2306
US

IV. Provider business mailing address

LOCKBOX #5422 PO BOX 31000
HONOLULU HI
96849-0001
US

V. Phone/Fax

Practice location:
  • Phone: 808-547-9231
  • Fax:
Mailing address:
  • Phone: 808-547-9231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: GREGG OISHI
Title or Position: ADMINISTRATOR
Credential:
Phone: 808-547-9231