Healthcare Provider Details

I. General information

NPI: 1548988058
Provider Name (Legal Business Name): OHANA ENDOSCOPY CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2022
Last Update Date: 07/18/2024
Certification Date: 07/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 FARRINGTON HWY UNIT 170
KAPOLEI HI
96707-2011
US

IV. Provider business mailing address

590 FARRINGTON HWY UNIT 170
KAPOLEI HI
96707-2011
US

V. Phone/Fax

Practice location:
  • Phone: 808-468-4600
  • Fax: 808-400-5883
Mailing address:
  • Phone: 808-468-4600
  • Fax: 808-400-5883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. ROZLYNN KEHAULANI DELA PINA
Title or Position: RN / CLINICAL DIRECTOR / ADMIN
Credential: DNP, APRN
Phone: 808-468-4600