# CANYON PRIMARY CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Kailua Primary Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295341550
- **Authorized official:** SARAH CANYON MD (OWNER)
- **Authorized official phone:** (808) 679-8518

## Contact information

- **Practice address:** 328 ULUNIU ST STE 103, KAILUA, HI 96734-2542
- **Practice address phone:** (808) 263-3020
- **Practice address fax:** (808) 762-1586
- **Mailing address:** 328 ULUNIU ST STE 103, KAILUA, HI 96734-2542

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/21/2020
- **Last updated:** 01/03/2022