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General NPI Number Information
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NPI Number | 1770779274
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Entity Type | Organization
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Legal Business Name | KIHEI CLINIC AND WAILEA MEDICAL SERVICES, LTD.
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Dates
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Enumeration Date | 09/18/2007
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Last Update Date | 09/18/2007
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Provider Practice Location Address
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Address Line | 2349 S KIHEI RD SUITE D
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City | KIHEI
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State | HI
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Zip | 96753-7202
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Country | US
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Telephone | 808-879-1440
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Fax | 808-879-7447
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Provider Business Mailing Address
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Address Line | 2349 S KIHEI RD SUITE D
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City | KIHEI
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State | HI
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Zip | 96753-7202
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Country | US
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Telephone |
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Fax | 808-879-7447
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ELMER HARRY RATZLAFF
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Credential | M.D.
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Telephone | 808-879-1440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0050X
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Taxonomy Name | Non-Surgical Family Planning Clinic/Center
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License Number | MD7001
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License Number State | HI
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