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General NPI Number Information
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NPI Number | 1255866505
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Entity Type | Organization
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Legal Business Name | MAHINAONA PEDIATRICS LLC
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Dates
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Enumeration Date | 04/25/2017
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Last Update Date | 04/25/2017
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Provider Practice Location Address
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Address Line | 3465 WAIALAE AVE SUITE 270
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City | HONOLULU
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State | HI
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Zip | 96816-2660
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Country | US
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Telephone | 808-737-4675
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Fax | 808-737-4978
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Provider Business Mailing Address
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Address Line | 3465 WAIALAE AVE SUITE 270
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City | HONOLULU
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State | HI
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Zip | 96816-2660
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Country | US
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Telephone | 808-737-4675
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Fax | 808-737-4978
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | DR. LISA KAHIKINA
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Credential | M.D.
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Telephone | 808-393-4959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 14942
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License Number State | HI
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