Healthcare Provider Details

I. General information

NPI: 1821166489
Provider Name (Legal Business Name): CARDIOTHORACIC ASSOCIATES OF HAWAII LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 02/15/2022
Certification Date: 02/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

642 ULUKAHIKI ST STE 205
KAILUA HI
96734-4418
US

IV. Provider business mailing address

642 ULUKAHIKI ST STE 205
KAILUA HI
96734-4418
US

V. Phone/Fax

Practice location:
  • Phone: 808-531-3311
  • Fax: 808-531-3311
Mailing address:
  • Phone: 808-531-3311
  • Fax: 808-531-3311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HENRY WAH LOUIE
Title or Position: PRESIDENT
Credential: MD
Phone: 808-531-3311