Healthcare Provider Details

I. General information

NPI: 1508733114
Provider Name (Legal Business Name): ZEN KAIAULU LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2025
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75-6016 ALII DR
KAILUA KONA HI
96740-2365
US

IV. Provider business mailing address

200 N VINEYARD BLVD STE A325-222
HONOLULU HI
96817-3950
US

V. Phone/Fax

Practice location:
  • Phone: 703-822-5669
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN W YOUNG JR.
Title or Position: HEALTH COACH
Credential: DSC
Phone: 703-822-5669