Healthcare Provider Details

I. General information

NPI: 1083810840
Provider Name (Legal Business Name): KAPIOLANI MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1990 AAMAKA PL
PEARL CITY HI
96782-1301
US

IV. Provider business mailing address

1990 AAMAKA PL
PEARL CITY HI
96782-1301
US

V. Phone/Fax

Practice location:
  • Phone: 808-222-6188
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number
License Number State

VIII. Authorized Official

Name: SUSAN LAFONTAINE
Title or Position: REHAB MANAGER
Credential:
Phone: 808-983-8235