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PACIFIC NEPHROLOGY LLC NPI 1265862221


NPI Information

NPI: 1265862221
Provider Name: PACIFIC NEPHROLOGY LLC
Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

Address:
95 MAUI LANI PKWY
WAILUKU, HI
ZIP 96793
Phone: (808) 244-1444
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PACIFIC NEPHROLOGY LLC is a medical specialty clinic center in Wailuku, HI. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). PACIFIC NEPHROLOGY LLC NPI is 1265862221. The provider is registered as an organization entity type.

The provider's business location address is:

95 MAUI LANI PKWY
WAILUKU, HI
ZIP 96793-416
Phone: (808) 244-1444
Fax: (808) 244-1445

The provider's authorized official is Jay Ian Lakkis .
The authorized official title is Physician - Member And Manager and has the following contact phone number (808) 244-1444.

The enumeration date for this NPI number is 11/12/2013 and was last updated on 3/17/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM2500XClinic/CenterMedical SpecialtyMD-12546HAWAIIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
154015501MEDICAIDHAWAII

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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