MEDICARE: KERI MIEKO TOKIMASA DELOS SANTOS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	LPN-15291	HI

General Provider Information

NPI Number	:	1679403851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KERI MIEKO TOKIMASA DELOS SANTOS

Provider Business Mailing Address
First Line	:	449 HOOMALU ST
Second Line	:
City	:	PEARL CITY
State	:	HI
Zip	:	96782-2923
Country	:	US
Telephone Number	:	808-382-5374
Fax Number	:

Provider Business Practice Location Address
First Line	:	449 HOOMALU ST
Second Line	:
City	:	PEARL CITY
State	:	HI
Zip	:	96782-2923
Country	:	US
Telephone Number	:	808-382-5374
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2026
Last Update Date	:	05/20/2026

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