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General NPI Number Information
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NPI Number | 1851529580
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Entity Type | Organization
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Legal Business Name | TRADE WINDS FAMILY MEDICINE, LLC
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Dates
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Enumeration Date | 07/01/2009
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 970 N KALAHEO AVE STE. C-306
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City | KAILUA
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State | HI
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Zip | 96734-1866
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Country | US
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Telephone | 808-263-7383
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Fax |
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Provider Business Mailing Address
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Address Line | 970 N KALAHEO AVE STE. C-306
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City | KAILUA
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State | HI
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Zip | 96734-1866
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Country | US
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Telephone | 808-263-7383
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. KIMBERLY KAY MCCAULEY LUND
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Credential | D.O.
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Telephone | 808-372-2420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | DOS-856
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License Number State | HI
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