Provider Demographics
NPI:1215004486
Name:KAM, KEVIN WK (RPH, CDE)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:WK
Last Name:KAM
Suffix:
Gender:M
Credentials:RPH, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:966 KAHEKA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-2427
Mailing Address - Country:US
Mailing Address - Phone:808-945-7875
Mailing Address - Fax:808-951-8507
Practice Address - Street 1:966 KAHEKA ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2427
Practice Address - Country:US
Practice Address - Phone:808-945-7875
Practice Address - Fax:808-951-8507
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH-1729183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist