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General NPI Number Information
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NPI Number | 1427135953
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Entity Type | Organization
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Legal Business Name | KAMUELA MEDICAL ASSOCIATES INC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 64-1066 B MAMALAHOA HWY
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City | KAMUELA
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State | HI
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Zip | 96743
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Country | US
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Telephone | 808-885-6006
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Fax | 808-885-0906
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Provider Business Mailing Address
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Address Line | 64-1066 B MAMALAHOA HWY
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City | KAMUELA
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State | HI
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Zip | 96743
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Country | US
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Telephone | 808-885-6006
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Fax | 808-885-0906
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Authorized Official
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Title or Position | ASST OFFICE MANAGER
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Name | CHARLYNN NC VELASCO
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Credential |
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Telephone | 808-885-6006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | MD4251
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License Number State | HI
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