Provider Demographics
NPI:1972374155
Name:CKSMD LLC
Entity Type:Organization
Organization Name:CKSMD LLC
Other - Org Name:CKSMD LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHIRAKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-225-5909
Mailing Address - Street 1:4348 WAIALAE AVE # 326
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5767
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:321 N KUAKINI ST STE 306
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2360
Practice Address - Country:US
Practice Address - Phone:808-225-5909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty