Provider Demographics
NPI:1366034894
Name:THE KIDS DOC, LLC
Entity Type:Organization
Organization Name:THE KIDS DOC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MD
Authorized Official - Prefix:DR
Authorized Official - First Name:NARO
Authorized Official - Middle Name:L
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-674-2555
Mailing Address - Street 1:579 FARRINGTON HWY STE 203
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-2027
Mailing Address - Country:US
Mailing Address - Phone:808-674-2555
Mailing Address - Fax:808-674-2988
Practice Address - Street 1:579 FARRINGTON HWY
Practice Address - Street 2:STE 203
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-2027
Practice Address - Country:US
Practice Address - Phone:808-674-2555
Practice Address - Fax:808-674-2988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-05
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty