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General NPI Number Information
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NPI Number | 1356639371
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Entity Type | Individual
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Provider Name | MARIYA KAI GOLD L.AC.
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Gender | Female
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Dates
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Enumeration Date | 07/11/2011
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Last Update Date | 07/11/2011
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Provider Practice Location Address
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Address Line | 320 ULUNIU ST STE #2
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City | KAILUA
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State | HI
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Zip | 96734-2529
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Country | US
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Telephone | 808-262-4550
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Fax | 808-261-7770
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Provider Business Mailing Address
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Address Line | 2419 FERDINAND AVE
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City | HONOLULU
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State | HI
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Zip | 96822-1910
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Country | US
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Telephone | 808-220-9297
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Fax | 808-261-7770
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | ACU 983
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License Number State | HI
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