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MAUI FAMILY MEDICINE NPI 1710511993


NPI Information

NPI: 1710511993
Provider Name: MAUI FAMILY MEDICINE
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 12D2177452

Address:
285 W KAAHUMANU AVE STE 205
KAHULUI, HI
ZIP 96732
Phone: (808) 351-2865
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MAUI FAMILY MEDICINE is a clinic center in Kahului, HI. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). MAUI FAMILY MEDICINE NPI is 1710511993. The provider is registered as an organization entity type.

The provider's business location address is:

285 W KAAHUMANU AVE STE 205
KAHULUI, HI
ZIP 96732-623
Phone: (808) 351-2865
Fax: (914) 222-8916

The provider's authorized official is Ivy Lou Hibbitt .
The authorized official title is Ceo/ Medical Director and has the following contact phone number (808) 212-8787.

The CLIA number assigned to this NPI record is 12D2177452 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/26/2020 and was last updated on 8/12/2020.


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
1261Q00000XClinic/CenterYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.