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General NPI Number Information
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NPI Number | 1326316977
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Entity Type | Organization
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Legal Business Name | KAHANA KAI LLC
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Dates
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Enumeration Date | 12/12/2011
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Last Update Date | 12/12/2011
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Provider Practice Location Address
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Address Line | 403 KAWAIHAE ST
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City | HONOLULU
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State | HI
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Zip | 96825-1206
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Country | US
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Telephone | 808-391-5582
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Fax |
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Provider Business Mailing Address
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Address Line | 7192 KALANIANAOLE HWY STE A143A209
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City | HONOLULU
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State | HI
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Zip | 96825-1800
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Country | US
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Telephone | 808-391-5582
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. JASON I KIM
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Credential | R.T.
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Telephone | 808-391-5582
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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License Number | R-2222
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License Number State | HI
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