KA'U WELLNESS LLC NPI 1538611173

NPI Information

NPI: 1538611173
Provider Name: KA'U WELLNESS LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 12D2026532

Address:
92-8691 LOTUS BLOSSOM LANE
#6-7
OCEAN VIEW, HI
ZIP 96737
Phone: (808) 939-8100
Get Directions

KA'U WELLNESS LLC is a primary care clinic center in Ocean View, HI. KA'U WELLNESS LLC NPI is 1538611173. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

92-8691 LOTUS BLOSSOM LANE
#6-7
OCEAN VIEW, HI
ZIP 96737-065
Phone: (808) 939-8100
Fax: (808) 829-3672

The provider's authorized official is Doede Deawn Donaugh .
The authorized official title is Owner/member-manager and has the following contact phone number (808) 939-8100.

The CLIA number assigned to this NPI record is 12D2026532 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/31/2016 and was last updated on 10/29/2020.

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
1	207Q00000X	Family Medicine		DOS-1310	HAWAII	No
2	363LF0000X	Nurse Practitioner	Family	APRN 1997	HAWAII	No
3	261QP2300X	Clinic/Center	Primary Care	DOS-1310	HAWAII	Yes

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
1	692584	MEDICAID	HAWAII

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

NPI Synchronization or Removal

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