Healthcare Provider Details

I. General information

NPI: 1851210306
Provider Name (Legal Business Name): MALAMA UROLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 N KUAKINI ST STE 612
HONOLULU HI
96817-2361
US

IV. Provider business mailing address

321 ILIHAU ST
KAILUA HI
96734-1876
US

V. Phone/Fax

Practice location:
  • Phone: 808-517-1019
  • Fax:
Mailing address:
  • Phone: 808-517-1019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: STEVE RIVERA
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 808-517-1019