Healthcare Provider Details

I. General information

NPI: 1467163774
Provider Name (Legal Business Name): KEN C ARAKAWA MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

1329 LUSITANA ST STE 206
HONOLULU HI
96813-2411
US

IV. Provider business mailing address

1329 LUSITANA ST STE 206
HONOLULU HI
96813-2411
US

V. Phone/Fax

Practice location:
  • Phone: 808-528-3888
  • Fax: 808-533-1448
Mailing address:
  • Phone: 808-528-3888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: JULITA MONTGOMERY
Title or Position: OFFICE MANAGER
Credential:
Phone: 808-457-3890