Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0505X | Family Doctor - Adult Medicine | MD-14815 | HI |
N | 207R00000X | Internist | MD-14815 | HI |
N | 111NI0900X | Internist | MD-14815 | HI |
Y | 208D00000X | General Practice Physician | MD-14815 | HI |
NPI | 1073714937 |
---|---|
Provider Name | Dr. Haku Kevin Kahoano |
First Address | Manhattan, KS 66503-2428 |
Second Address | Jamestown, CA 95327-9737 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2007 |
Last Update Date | 18/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
VAD000 | (02) | HI |