| Keizer Kauka Llc | |
|
425 Kamehameha Hwy Ste 1 Pearl City HI 96782-3295 | |
| (808) 347-1645 | |
| (866) 592-3149 |
| Full Name | Keizer Kauka Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 425 Kamehameha Hwy Ste 1, Pearl City, Hawaii |
| Authorized Official Name and Position | Doreen Fukushima (PROVIDER) |
| Authorized Official Contact | 8086641104 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Keizer Kauka Llc 425 Kamehameha Hwy Ste 1 Pearl City HI 96782-3295 Ph: (808) 347-1645 | Keizer Kauka Llc 425 Kamehameha Hwy Ste 1 Pearl City HI 96782-3295 Ph: (808) 347-1645 |
| NPI Number | 1093390056 |
|---|---|
| Provider Enumeration Date | 03/11/2021 |
| Last Update Date | 08/02/2021 |
| Certification Date | 08/02/2021 |
| Medicare PECOS PAC ID | 9537563713 |
|---|---|
| Medicare Enrollment ID | O20210810002954 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093390056 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Doreen Lanae Fukushima |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205030111 PECOS PAC ID: 9436273919 Enrollment ID: I20191220002341 |
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