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4819 Kilauea Ave Ste 7 Honolulu HI 96816-5712 | |
| (310) 709-5492 | |
| (808) 808-1324 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 4819 Kilauea Ave Ste 7, Honolulu, Hawaii |
| Authorized Official Name and Position | Taryn Wright (PRACTICE MANAGER) |
| Authorized Official Contact | 8088081324 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
4819 Kilauea Ave Ste 7 Honolulu HI 96816-5712 Ph: (310) 709-5492 | 4819 Kilauea Ave Ste 7 Honolulu HI 96816-5712 Ph: (310) 709-5492 |
| NPI Number | 1881437168 |
|---|---|
| Provider Enumeration Date | 06/14/2024 |
| Last Update Date | 09/30/2024 |
| Medicare PECOS PAC ID | 5698212934 |
|---|---|
| Medicare Enrollment ID | O20240803000497 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881437168 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| Provider Name | Christopher Dubuque |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639545528 PECOS PAC ID: 4789978685 Enrollment ID: I20190724000884 |
| Provider Name | April Leilani Solomon Ramos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013775733 PECOS PAC ID: 7416399225 Enrollment ID: I20240524001844 |
| Provider Name | Lauren Quednow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568239739 PECOS PAC ID: 6204370570 Enrollment ID: I20240627001206 |
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