Healthcare Provider Details

I. General information

NPI: 1730056292
Provider Name (Legal Business Name): WAIKIKI HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2025
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

932 WARD AVE
HONOLULU HI
96814-2131
US

IV. Provider business mailing address

277 OHUA AVE
HONOLULU HI
96815-3695
US

V. Phone/Fax

Practice location:
  • Phone: 808-922-4787
  • Fax: 808-922-4950
Mailing address:
  • Phone: 808-922-4787
  • Fax: 808-922-4950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: EZRA MICAH GAY-YA
Title or Position: HR MANAGER
Credential:
Phone: 808-537-8417