Organization
KAMUELA MEDICAL ASSOCIATES INC
Active
Other names
Jed A Groom MD dba Kamuela Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLYNN NC VELASCO (ASST OFFICE MANAGER)
(808) 885-6006
Entity
Organization
Contact information
Practice address
64-1066 B MAMALAHOA HWY, KAMUELA, HI 96743
(808) 885-6006
(808) 885-0906
Mailing address
64-1066 B MAMALAHOA HWY, KAMUELA, HI 96743
(808) 885-6006
(808) 885-0906
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD4251
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00376101
—
HI
01
—
3020
HMSA BCBS
HI
Enumeration date
11/01/2006
Last updated
08/22/2020
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