| Hoala I Ke Ola Llc | |
|
801 S Beretania St Honolulu HI 96813-2501 | |
| (808) 753-3935 | |
| Not Available |
| Full Name | Hoala I Ke Ola Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 801 S Beretania St, Honolulu, Hawaii |
| Authorized Official Name and Position | Robin Wentzel (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 8087533965 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hoala I Ke Ola Llc Po Box 1540 Honolulu HI 96806-1540 Ph: (808) 753-3935 | Hoala I Ke Ola Llc 801 S Beretania St Honolulu HI 96813-2501 Ph: (808) 753-3935 |
| NPI Number | 1851084057 |
|---|---|
| Provider Enumeration Date | 06/01/2023 |
| Last Update Date | 05/22/2024 |
| Medicare PECOS PAC ID | 6406298363 |
|---|---|
| Medicare Enrollment ID | O20240523000287 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851084057 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Derek Uemura |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801823521 PECOS PAC ID: 2163552514 Enrollment ID: I20120111000150 |
| Provider Name | Christina Mb Wang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356853527 PECOS PAC ID: 5698821486 Enrollment ID: I20180815003316 |
| Provider Name | Michelle Kendall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417534892 PECOS PAC ID: 2163824897 Enrollment ID: I20210716001801 |
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