Provider Demographics
NPI:1578653127
Name:KEN C. ARAKAWA MD INC.
Entity Type:Organization
Organization Name:KEN C. ARAKAWA MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:JULITA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-528-3888
Mailing Address - Street 1:1329 LUSITANA ST STE 206
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2411
Mailing Address - Country:US
Mailing Address - Phone:808-528-3888
Mailing Address - Fax:808-533-1448
Practice Address - Street 1:1329 LUSITANA ST STE 206
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2411
Practice Address - Country:US
Practice Address - Phone:808-528-3888
Practice Address - Fax:808-533-1448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI5877261QV0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QV0200XAmbulatory Health Care FacilitiesClinic/CenterVA
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIB0029104OtherHMSA
HI02608001Medicaid
HIH51725Medicare PIN
HI02608001Medicaid
HI0788670001Medicare NSC