Provider Demographics
NPI:1255867404
Name:TAUM, COURTNEY KIELEMAIKALANI (MD)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:KIELEMAIKALANI
Last Name:TAUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:KIELEMAIKALANI
Other - Last Name:GADDIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:615 PIIKOI ST STE 1501
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-3142
Mailing Address - Country:US
Mailing Address - Phone:808-006-2180
Mailing Address - Fax:808-600-2199
Practice Address - Street 1:1319 PUNAHOU ST
Practice Address - Street 2:#741
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1001
Practice Address - Country:US
Practice Address - Phone:808-391-1558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-10
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
HIMD21045208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program