Organization
HONOLULU MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM ROCHA (COO)
(808) 537-2211
Entity
Organization
Contact information
Practice address
550 S BERETANIA ST, 4TH FLOOR, HONOLULU, HI 96813-2496
(808) 537-2211
Mailing address
550 S BERETANIA ST, 4TH FLOOR, HONOLULU, HI 96813-2496
(808) 537-2211
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
MD-5757
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026245-03
—
HI
01
—
504423
HMN
HI
01
—
5838611
FIRST HEALTH
HI
01
—
896441
UHA
HI
01
—
MD5757
MDX
HI
Enumeration date
11/20/2006
Last updated
08/22/2020
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