Healthcare Provider Details

I. General information

NPI: 1730044983
Provider Name (Legal Business Name): WAIOLA ANESTHESIA PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 FARRINGTON HWY UNIT 170
KAPOLEI HI
96707-2011
US

IV. Provider business mailing address

PO BOX 700309
KAPOLEI HI
96709-0309
US

V. Phone/Fax

Practice location:
  • Phone: 808-468-4600
  • Fax:
Mailing address:
  • Phone: 808-744-0517
  • Fax: 808-693-8060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: DR. VINCENT ICALIA
Title or Position: PARTNER
Credential: CRNA
Phone: 708-466-6256