Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | MD-9120 | HI |
NPI | 1033291919 |
---|---|
Provider Name | Dr. Kenneth C.m. Lee |
First Address | Aiea, HI 96701-4300 |
Second Address | Aiea, HI 96701-4300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 08/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00C0206015 | HMSA (01) | HI |
077714 | (05) | HI |
8816444 | UHA (01) | HI |
F92566 | (02) | HI |