Healthcare Provider Details

I. General information

NPI: 1073572665
Provider Name (Legal Business Name): DUKEE KIM, M.D. A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2006
Last Update Date: 12/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 KAPIOLANI BLVD SUITE 416
HONOLULU HI
96814-4401
US

IV. Provider business mailing address

1441 KAPIOLANI BLVD SUITE 416
HONOLULU HI
96814-4401
US

V. Phone/Fax

Practice location:
  • Phone: 808-946-2442
  • Fax: 808-943-7147
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number02501
License Number StateHI

VIII. Authorized Official

Name: DR. DUKEE KIM
Title or Position: PRESIDENT
Credential: M.D.
Phone: 808-946-2442