Organization
BAY CARE MED CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JED A GROOM (CEO)
(808) 206-5349
Entity
Organization
Contact information
Practice address
16-540 KEAAU PAHOA RD, STE 2-177, KEAAU, HI 96749-8155
(808) 206-5349
Mailing address
16-540 KEAAU PAHOA RD, STE 2-177, KEAAU, HI 96749-8155
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD4251
HI
Other
Enumeration date
08/14/2009
Last updated
01/15/2010
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