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General NPI Number Information
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NPI Number | 1689024895
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Entity Type | Organization
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Legal Business Name | KEN HEALTH CARE INTERNATIONAL, INC.
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Dates
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Enumeration Date | 06/18/2016
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Last Update Date | 06/18/2016
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Provider Practice Location Address
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Address Line | 2250 KALAKAUA AVE SUITE 407
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City | HONOLULU
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State | HI
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Zip | 96815-2542
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Country | US
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Telephone | 808-367-0513
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Fax | 808-367-0514
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Provider Business Mailing Address
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Address Line | 2250 KALAKAUA AVE SUITE 407
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City | HONOLULU
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State | HI
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Zip | 96815-2542
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Country | US
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Telephone | 808-367-0513
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Fax | 808-367-0514
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Authorized Official
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Title or Position | MEIDCAL DIRECTOR
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Name | DR. EMI OTA
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Credential | M.D.
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Telephone | 808-367-0513
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 18532
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License Number State | HI
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