Organization
WAIKOLOA MEDICAL ARTS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BAYARDO JOSE AVILES (ADMINISTRATOR)
(808) 960-5792
Entity
Organization
Contact information
Practice address
64-1035 MAMALAHOA HWY, SUITE K, KAMUELA, HI 96743-8440
(808) 883-9785
(808) 883-9783
Mailing address
64-1035 MAMALAHOA HWY, SUITE K, KAMUELA, HI 96743-8440
(808) 883-9785
(808) 883-9783
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
MD7441
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A0088581
HMSA BCBS HAWAII
HI
05
—
06811102
—
HI
Enumeration date
11/15/2006
Last updated
02/16/2017
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