Provider Demographics
NPI:1184833709
Name:KAUAI HOLISTIC MEDICINE INC.
Entity type:Organization
Organization Name:KAUAI HOLISTIC MEDICINE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:YAREMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-823-0994
Mailing Address - Street 1:4504 KUKUI ST
Mailing Address - Street 2:SUITE 13
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-1701
Mailing Address - Country:US
Mailing Address - Phone:808-823-0994
Mailing Address - Fax:808-823-0995
Practice Address - Street 1:4504 KUKUI ST
Practice Address - Street 2:SUITE 13
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-1701
Practice Address - Country:US
Practice Address - Phone:808-823-0994
Practice Address - Fax:808-823-0995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD9581208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty