Healthcare Provider Details

I. General information

NPI: 1235862137
Provider Name (Legal Business Name): HAWAII DIALYSIS PARTNERS AT KUAKINI, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2022
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 N KUAKINI ST
HONOLULU HI
96817-2306
US

IV. Provider business mailing address

860 HILLVIEW CT STE 250
MILPITAS CA
95035-4571
US

V. Phone/Fax

Practice location:
  • Phone: 650-404-3600
  • Fax:
Mailing address:
  • Phone: 650-404-3600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RYAN PARDO
Title or Position: GENERAL COUNSEL
Credential:
Phone: 425-213-9398