Healthcare Provider Details

I. General information

NPI: 1992609994
Provider Name (Legal Business Name): KALEOIKAIKAOKALANI O'NEAL ANDERSON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 KUNEHI ST APT 206
KAPOLEI HI
96707-2069
US

IV. Provider business mailing address

98-139 KEANAE ST
AIEA HI
96701-4316
US

V. Phone/Fax

Practice location:
  • Phone: 808-674-6641
  • Fax:
Mailing address:
  • Phone: 808-358-7653
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number26-2850846
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: