Provider Demographics
NPI:1558500405
Name:ORTHOPEDIC SPECIALISTS KAUAI, LLC
Entity Type:Organization
Organization Name:ORTHOPEDIC SPECIALISTS KAUAI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-384-1822
Mailing Address - Street 1:PO BOX 1162
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-5162
Mailing Address - Country:US
Mailing Address - Phone:808-245-4800
Mailing Address - Fax:
Practice Address - Street 1:3125 AKAHI ST
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1106
Practice Address - Country:US
Practice Address - Phone:808-245-4800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-17
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty