=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285756650
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KAY ANGELA BAUMAN MD, MPH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/04/2007
-----------------------------------------------------
Last Update Date | 07/09/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 919 ALA MOANA BLVD RM. 407
-----------------------------------------------------
City | HONOLULU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96814-4920
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-587-3376
-----------------------------------------------------
Fax | 808-587-3378
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 59-479 HOALIKE RD
-----------------------------------------------------
City | HALEIWA
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96712-9524
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-638-7588
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 8046
-----------------------------------------------------
License Number State | HI
-----------------------------------------------------