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General NPI Number Information
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NPI Number | 1487997516
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Entity Type | Individual
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Provider Name | MICHAEL KALANI KENMUN TOM M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/27/2013
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Last Update Date | 12/07/2022
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Provider Practice Location Address
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Address Line | 550 S BERETANIA ST STE 601
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City | HONOLULU
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State | HI
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Zip | 96813-2423
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Country | US
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Telephone | 808-691-8877
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Fax | 808-691-8875
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Provider Business Mailing Address
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Address Line | 550 S BERETANIA ST STE 601
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City | HONOLULU
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State | HI
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Zip | 96813-2423
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Country | US
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Telephone | 808-691-8877
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Fax | 808-691-8875
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 18360
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 18360
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License Number State | HI
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