# KAUAI OSTEOPATHIC, INC

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

## Provider details

- **NPI number:** 1720190929
- **Authorized official:** LISA CHUN D.O. (OWNER/PHYSICIAN)
- **Authorized official phone:** (808) 742-1200

## Contact information

- **Practice address:** 3483 WELIWELI RD, KOLOA, HI 96756-8546
- **Practice address phone:** (808) 742-1200
- **Practice address fax:** (808) 742-1206
- **Mailing address:** 3483 WELIWELI RD, P.O. BOX 817, KOLOA, HI 96756-8546
- **Mailing address phone:** (808) 742-1200
- **Mailing address fax:** (808) 742-1206

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | 918 | HI | Yes |

## Other

- **Enumeration date:** 09/01/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 23557-2 | HMSA NON-PARTICIPATING NU | HI |