Healthcare Provider Details

I. General information

NPI: 1023202843
Provider Name (Legal Business Name): DAVID A. KAMINSKAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2007
Last Update Date: 05/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

642 ULUKAHIKI STREET SUITE 300
KAILUA HI
96734-4439
US

IV. Provider business mailing address

642 ULUKAHIKI STREET SUITE 300
KAILUA HI
96734-4439
US

V. Phone/Fax

Practice location:
  • Phone: 808-261-4476
  • Fax: 808-263-4476
Mailing address:
  • Phone: 808-261-4476
  • Fax: 808-263-4476

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberG82098
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberG82098
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD8443
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: