Healthcare Provider Details

I. General information

NPI: 1760724447
Provider Name (Legal Business Name): SABA KAM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2013
Last Update Date: 03/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1288 KAPIOLANI BLVD APT 1508
HONOLULU HI
96814-2868
US

IV. Provider business mailing address

1288 KAPIOLANI BLVD APT 1508
HONOLULU HI
96814-2868
US

V. Phone/Fax

Practice location:
  • Phone: 808-382-8199
  • Fax:
Mailing address:
  • Phone: 808-382-8199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberAPRN-1148
License Number StateHI

VIII. Authorized Official

Name: SABA KAM
Title or Position: APRN
Credential:
Phone: 808-382-8199