| Trade Winds Family Medicine, Llc | |
|
970 N Kalaheo Ave Ste. C-306 Kailua HI 96734-1866 | |
| (808) 263-7383 | |
| Not Available |
| Full Name | Trade Winds Family Medicine, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 970 N Kalaheo Ave, Kailua, Hawaii |
| Authorized Official Name and Position | Kimberly Kay Mccauley Lund (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8083722420 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trade Winds Family Medicine, Llc 970 N Kalaheo Ave Ste. C-306 Kailua HI 96734-1866 Ph: (808) 263-7383 | Trade Winds Family Medicine, Llc 970 N Kalaheo Ave Ste. C-306 Kailua HI 96734-1866 Ph: (808) 263-7383 |
| NPI Number | 1851529580 |
|---|---|
| Provider Enumeration Date | 07/01/2009 |
| Last Update Date | 07/01/2009 |
| Medicare PECOS PAC ID | 2860539269 |
|---|---|
| Medicare Enrollment ID | O20091016000115 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851529580 | NPI | - | NPPES |
| 56992301 | Medicaid | HI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | DOS-856 (Hawaii) | Primary |
| Provider Name | Susan M Christensen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326019704 PECOS PAC ID: 6507751229 Enrollment ID: I20040220000038 |
| Provider Name | Kimberly K.m. Lund |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831315951 PECOS PAC ID: 1456384627 Enrollment ID: I20050917000096 |
| Provider Name | Elicia A Lujan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396995775 PECOS PAC ID: 5193889178 Enrollment ID: I20161214000024 |
| Provider Name | Le Kim Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891825014 PECOS PAC ID: 3779673371 Enrollment ID: I20180717002366 |
| Provider Name | Megan E Bradham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215461819 PECOS PAC ID: 1557632668 Enrollment ID: I20200626001717 |
| Provider Name | Marilee Kuulei Owens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982250015 PECOS PAC ID: 3678981727 Enrollment ID: I20230526000964 |
| Provider Name | Andie H Kida |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114706207 PECOS PAC ID: 6901253558 Enrollment ID: I20231103002189 |
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