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)CodeLicenseStatePrimary
General Practice Physician
Group: 193400000X SINGLE SPECIALTY GROUP
208D00000X Yes

Addresses

Primary practice location

634 Kalihi St.
Honolulu, HI 96819

Mailing address

634 Kalihi St.
Honolulu, HI 96819
Phone (808) 845-3911

Other providers in Honolulu, HI

All providers in Honolulu, HI · General Practice Physician in Hawaii

Sources for this page

Verify at the official NPI Registry.