Organization
CANYON PRIMARY CARE LLC
Active
Other names
Kailua Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH CANYON MD (OWNER)
(808) 679-8518
Entity
Organization
Contact information
Practice address
328 ULUNIU ST STE 103, KAILUA, HI 96734-2542
(808) 263-3020
(808) 762-1586
Mailing address
328 ULUNIU ST STE 103, KAILUA, HI 96734-2542
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
814873
—
HI
Enumeration date
09/21/2020
Last updated
01/03/2022
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