Healthcare Provider Details

I. General information

NPI: 1033933619
Provider Name (Legal Business Name): OHANA DOC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2024
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1254 S KIHEI RD UNIT 926
KIHEI HI
96753-4039
US

IV. Provider business mailing address

1254 S KIHEI RD UNIT 926
KIHEI HI
96753-4039
US

V. Phone/Fax

Practice location:
  • Phone: 808-868-1977
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NATHAN T HARRINGTON-FOSTER
Title or Position: CEO
Credential: MD
Phone: 808-868-1977