Organization
KAPOLEI FAMILY MEDICAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN KIM M.D. (VICE PRESIDENT)
(808) 674-2930
Entity
Organization
Contact information
Practice address
590 FARRINGTON HWY, SUITE 526A, KAPOLEI, HI 96707-2009
(808) 674-2930
Mailing address
590 FARRINGTON HWY, SUITE 526A, KAPOLEI, HI 96707-2009
(808) 674-2930
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD12184
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50100815
—
HI
05
—
52141018
—
HI
01
—
H55656
MEDICARE ID PTAN GROUP
HI
Enumeration date
11/14/2006
Last updated
04/04/2011
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