634 Kalihi Medical and Wellness Clinic, LLC
Organization Active NPI General Practice Physician · Honolulu, HI
NPI 1295487882 · NPPES record last updated Jan 25, 2022
Key facts
- NPI
- 1295487882
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Physician 208D00000X
- Legal business name
- 634 KALIHI MEDICAL AND WELLNESS CLINIC, LLC
- Practice address
- 634 Kalihi St.
Honolulu, HI 96819 - Phone
- (808) 845-3911
- Fax
- (808) 848-0870
- NPI assigned
- Jan 25, 2022
- Organization subpart
- Yes
- Parent organization (as reported)
- 634 KALIHI MEDICAL AND WELLNESS CLINIC, LLC
Authorized official
- Name
- Rodrigo Gose Bristol, MD
- Title
- M.D.
- Phone
- (808) 845-3911
National Provider Directory
- Part of
- 634 Kalihi Medical and Wellness Clinic LLC
Locations
634 Kalihi St
Honolulu, HI 96819
Phone (808) 841-7288
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician |
208D00000X | Yes |
Addresses
Primary practice location
634 Kalihi St.
Honolulu, HI 96819
Mailing address
634 Kalihi St.
Honolulu, HI 96819
Phone (808) 845-3911
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.