Healthcare Provider Details

I. General information

NPI: 1154296390
Provider Name (Legal Business Name): OHANA URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2025
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 S PUUNENE AVE STE 108
KAHULUI HI
96732-2192
US

IV. Provider business mailing address

PO BOX 700127
KAPOLEI HI
96709-0127
US

V. Phone/Fax

Practice location:
  • Phone: 808-333-2420
  • Fax: 808-748-3311
Mailing address:
  • Phone: 808-949-9585
  • Fax: 808-748-3311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: JASON CHAN
Title or Position: AUTHORIZED OFFICIAL
Credential: PA-C
Phone: 808-333-2420