Provider Demographics
NPI:1619044120
Name:HAWAII CENTER FOR REPRODUCTIVE MEDICINE AND SURGERY
Entity Type:Organization
Organization Name:HAWAII CENTER FOR REPRODUCTIVE MEDICINE AND SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:K
Authorized Official - Last Name:VU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-261-4166
Mailing Address - Street 1:642 ULUKAHIKI ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4400
Mailing Address - Country:US
Mailing Address - Phone:808-261-4166
Mailing Address - Fax:808-261-4086
Practice Address - Street 1:642 ULUKAHIKI ST
Practice Address - Street 2:SUITE 300
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-4400
Practice Address - Country:US
Practice Address - Phone:808-261-4166
Practice Address - Fax:808-261-4086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD9740261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI51780Medicare ID - Type Unspecified
HIF40083Medicare UPIN