Healthcare Provider Details

I. General information

NPI: 1164349528
Provider Name (Legal Business Name): ALYSSA KAM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1967 HOOKUMU PL
PEARL CITY HI
96782-1767
US

IV. Provider business mailing address

1967 HOOKUMU PL
PEARL CITY HI
96782-1767
US

V. Phone/Fax

Practice location:
  • Phone: 808-979-5330
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH-5230
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: