Provider Demographics
NPI:1568655686
Name:KE OLA MAMO
Entity Type:Organization
Organization Name:KE OLA MAMO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOELENE
Authorized Official - Middle Name:
Authorized Official - Last Name:LONO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-848-8000
Mailing Address - Street 1:321 N KUAKINI ST STE 308
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2360
Mailing Address - Country:US
Mailing Address - Phone:808-440-6852
Mailing Address - Fax:
Practice Address - Street 1:321 N KUAKINI ST STE 807
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2395
Practice Address - Country:US
Practice Address - Phone:808-440-6852
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH100834Medicare PIN