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General NPI Number Information
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NPI Number | 1609378504
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Entity Type | Organization
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Legal Business Name | KAILUA INTEGRATIVE MEDICINE LLC
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Dates
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Enumeration Date | 03/06/2018
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Last Update Date | 03/06/2018
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Provider Practice Location Address
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Address Line | 354 ULUNIU ST STE 404
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City | KAILUA
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State | HI
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Zip | 96734-2534
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Country | US
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Telephone | 808-779-4669
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Fax |
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Provider Business Mailing Address
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Address Line | 354 ULUNIU ST STE 404
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City | KAILUA
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State | HI
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Zip | 96734-2534
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Country | US
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Telephone | 808-779-4669
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Fax |
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Authorized Official
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Title or Position | CO-FOUNDER
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Name | DR. LANDON OPUNUI
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Credential | N.D.
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Telephone | 808-779-4669
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | ND-251
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License Number State | HI
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