Healthcare Provider Details

I. General information

NPI: 1922131838
Provider Name (Legal Business Name): SOLOMON KIMOKEO KAHALEWAI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 KAIWI STREET
KAUNAKAKAI HI
96748
US

IV. Provider business mailing address

PO BOX 994
KAUNAKAKAI HI
96748-0994
US

V. Phone/Fax

Practice location:
  • Phone: 808-553-9892
  • Fax: 808-553-4411
Mailing address:
  • Phone: 808-553-9892
  • Fax: 808-553-4411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: