Provider Demographics
NPI:1134133713
Name:HUI MALAMA OLA NA 'OIWI
Entity Type:Organization
Organization Name:HUI MALAMA OLA NA 'OIWI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALLING CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:ADINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLAN FRONIUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-265-1292
Mailing Address - Street 1:1438 KILAUEA AVE
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-4286
Mailing Address - Country:US
Mailing Address - Phone:808-969-9220
Mailing Address - Fax:808-961-4794
Practice Address - Street 1:1438 KILAUEA AVE
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4286
Practice Address - Country:US
Practice Address - Phone:808-969-9220
Practice Address - Fax:808-961-4794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI490920Medicaid