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General NPI Number Information
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NPI Number | 1134317571
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Entity Type | Organization
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Legal Business Name | WAIMEA PACIFIC ENTERPRISES, LLC
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Dates
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Enumeration Date | 10/11/2007
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Last Update Date | 10/28/2008
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Provider Practice Location Address
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Address Line | 65-1267 KAWAIHAE RD
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City | KAMUELA
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State | HI
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Zip | 96743-8406
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Country | US
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Telephone | 808-885-7511
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Fax | 808-885-0933
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Provider Business Mailing Address
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Address Line | PO BOX 7109
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City | KAMUELA
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State | HI
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Zip | 96743-7109
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Country | US
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Telephone | 808-885-7511
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Fax | 808-885-0933
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Authorized Official
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Title or Position | OWNER
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Name | DR. LYN MICHELLE LAM
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Credential | M.D.
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Telephone | 808-885-7511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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