Healthcare Provider Details

I. General information

NPI: 1689468803
Provider Name (Legal Business Name): KEIKI DOC PEDIATRIC URGENT CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2025
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76-6225 KUAKINI HWY STE C101
KAILUA KONA HI
96740-3212
US

IV. Provider business mailing address

PO BOX 2131
KEALAKEKUA HI
96750-2131
US

V. Phone/Fax

Practice location:
  • Phone: 808-329-7067
  • Fax:
Mailing address:
  • Phone: 773-758-3874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. VALERIE E LAWRENCE
Title or Position: OWNER/CEO
Credential: MD
Phone: 773-758-3874