# KAHALA CLINIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053666842
- **Authorized official:** JASON RICHARD KEIFER M.D. (OWNER)
- **Authorized official phone:** (808) 542-7349

## Contact information

- **Practice address:** 4211 WAIALAE AVE, SUITE 207, HONOLULU, HI 96816-5319
- **Practice address phone:** (808) 542-7349
- **Mailing address:** 4211 WAIALAE AVE, SUITE 207, HONOLULU, HI 96816-5319

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0804X | Child & Adolescent Psychiatry Physician | MD12987 | HI | Yes |

## Other

- **Enumeration date:** 07/17/2012
- **Last updated:** 07/17/2012