Healthcare Provider Details

I. General information

NPI: 1598860124
Provider Name (Legal Business Name): WAIMEA MEDICAL ASSOCIATES LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 07/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67-1123 MAMALAHOA HWY SUITE 128
KAMUELA HI
96743-8451
US

IV. Provider business mailing address

67-1123 MAMALAHOA HWY SUITE 128
KAMUELA HI
96743-8451
US

V. Phone/Fax

Practice location:
  • Phone: 808-885-7351
  • Fax: 808-885-9852
Mailing address:
  • Phone: 808-885-7351
  • Fax: 808-885-9852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN M DAWSON
Title or Position: SENIOR PARTNER
Credential: MD
Phone: 808-885-0342