Provider Demographics
NPI:1356511810
Name:PAUL A. KAIWI, JR. MD INC
Entity Type:Organization
Organization Name:PAUL A. KAIWI, JR. MD INC
Other - Org Name:PROGRESSIVE MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:KAIWI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-877-6333
Mailing Address - Street 1:444 HANA HWY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-2315
Mailing Address - Country:US
Mailing Address - Phone:808-877-6333
Mailing Address - Fax:808-877-7100
Practice Address - Street 1:444 HANA HWY
Practice Address - Street 2:SUITE 201
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-2315
Practice Address - Country:US
Practice Address - Phone:808-877-6333
Practice Address - Fax:808-877-7100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD 13020208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty