Individual
KELSIE TADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 ALA MOANA BLVD STE 1-302, HONOLULU, HI 96813-4925
(808) 528-3657
(808) 524-6552
Mailing address
500 ALA MOANA BLVD STE 1-302, HONOLULU, HI 96813-4925
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
AMD-654
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06819901
—
HI
Enumeration date
10/07/2015
Last updated
10/29/2024
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