# KE OLA PONO OHANA FAMILY MEDICINE CLINIC, LLC

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

## Provider details

- **NPI number:** 1689056699
- **Authorized official:** DR. MELANIE M PAYANAL M.D. (CEO)
- **Authorized official phone:** (808) 536-0300

## Contact information

- **Practice address:** 99-128 AIEA HEIGHTS DR, SUITE 505, AIEA, HI 96701-3925
- **Practice address phone:** (808) 536-0300
- **Practice address fax:** (808) 536-0320
- **Mailing address:** 848 S BERETANIA ST, SUITE 400, HONOLULU, HI 96813-2551
- **Mailing address phone:** (808) 536-0300
- **Mailing address fax:** (808) 536-0320

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD - 18089 | HI | Yes |

## Other

- **Enumeration date:** 06/25/2015
- **Last updated:** 08/17/2015