Organization
KOA COMMUNITY CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CORINNE MAUL DE SOTO (EXECUTIVE DIRECTOR)
(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
261QC1500X
Community Health Clinic/Center
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Enumeration date
04/13/2020
Last updated
07/03/2024
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