Provider Demographics
NPI:1922313816
Name:MAUI LEIALOHA OB GYN LLC
Entity Type:Organization
Organization Name:MAUI LEIALOHA OB GYN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:AVANI
Authorized Official - Middle Name:
Authorized Official - Last Name:LAKHANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-317-5464
Mailing Address - Street 1:71 KANOA ST STE 201
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-5816
Mailing Address - Country:US
Mailing Address - Phone:808-244-0401
Mailing Address - Fax:
Practice Address - Street 1:71 KANOA ST STE 201
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-5816
Practice Address - Country:US
Practice Address - Phone:808-244-0401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-16
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD13987207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty