Organization
KOKUA KALIHI VALLEY COMPREHENSIVE FAMILY SERVICES
Active
Organization
KOKUA KALIHI VALLEY COMPREHENSIVE FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID DERAUF MD (EXECUTIVE DIRECTOR)
(808) 791-9400
Entity
Organization
Contact information
Practice address
2239 N SCHOOL ST, HONOLULU, HI 96819-2539
(808) 791-9400
(808) 848-0979
Mailing address
2239 N SCHOOL ST, HONOLULU, HI 96819-2539
(808) 791-9400
(808) 848-0979
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
121800
MEDICARE ID
HI
05
—
598237
—
HI
Enumeration date
01/05/2007
Last updated
11/25/2014
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