Healthcare Provider Details

I. General information

NPI: 1992186811
Provider Name (Legal Business Name): KAPIOLANI MEDICAL CENTER FOR WOMEN AND CHILDREN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2015
Last Update Date: 06/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1319 PUNAHOU ST
HONOLULU HI
96826-1001
US

IV. Provider business mailing address

1319 PUNAHOU ST
HONOLULU HI
96826-1001
US

V. Phone/Fax

Practice location:
  • Phone: 808-983-8219
  • Fax:
Mailing address:
  • Phone: 808-983-8219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License NumberHI-1273
License Number StateHI

VIII. Authorized Official

Name: MRS. KIMI PEREZ
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential: MS CCC-SLP
Phone: 808-983-8219