Organization
KOA CLINIC, INC
Active
Organization
KOA CLINIC, INC
Active
Other names
Koa Clinic of Integrative Healing
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CORINNE MAUL DE SOTO ND (PRESIDENT)
(808) 638-3343
Entity
Organization
Contact information
Practice address
75-5995 KUAKINI HWY STE 213, KAILUA KONA, HI 96740-2120
(808) 638-3343
(844) 308-3545
Mailing address
75-5995 KUAKINI HWY STE 213, KAILUA KONA, HI 96740-2120
(808) 638-3343
(844) 308-3545
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
—
—
261Q00000X
Clinic/Center
Primary
258
HI
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
01/12/2018
Last updated
07/03/2024
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