Healthcare Provider Details

I. General information

NPI: 1831450782
Provider Name (Legal Business Name): DONGHEE KIM NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2012
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PUNCHBOWL ST
HONOLULU HI
96813-2402
US

IV. Provider business mailing address

1301 PUNCHBOWL ST
HONOLULU HI
96813-2402
US

V. Phone/Fax

Practice location:
  • Phone: 808-691-4771
  • Fax: 808-691-4507
Mailing address:
  • Phone: 808-691-4771
  • Fax: 808-691-4507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP121650
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN-5259
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number95018884
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95018884
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number95018884
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: