| Ke Ola Mamo | |
|
321 N Kuakini St Ste 308 Honolulu HI 96817-2360 | |
| (808) 440-6852 | |
| (808) 440-6878 |
| Full Name | Ke Ola Mamo |
|---|---|
| Speciality | Internal Medicine |
| Location | 321 N Kuakini St Ste 308, Honolulu, Hawaii |
| Authorized Official Name and Position | Shami Rafanan (MEDICAL BILLER) |
| Authorized Official Contact | 8084406852 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ke Ola Mamo 680 Iwilei Rd Ste 500 Honolulu HI 96817-5389 Ph: (808) 440-6852 | Ke Ola Mamo 321 N Kuakini St Ste 308 Honolulu HI 96817-2360 Ph: (808) 440-6852 |
| NPI Number | 1700979531 |
|---|---|
| Provider Enumeration Date | 10/02/2006 |
| Last Update Date | 01/13/2023 |
| Medicare PECOS PAC ID | 0143245100 |
|---|---|
| Medicare Enrollment ID | O20051008000097 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700979531 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Nicole Lum |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1841601937 PECOS PAC ID: 3173888435 Enrollment ID: I20181003001877 |
| Provider Name | Kristie W Yeung |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1376200063 PECOS PAC ID: 9436523065 Enrollment ID: I20230322003006 |
| Provider Name | Garla Kuuipoaloha Souza-roy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437660750 PECOS PAC ID: 4981060688 Enrollment ID: I20230523001855 |
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