Provider Demographics
NPI:1265584502
Name:EGAMI, DARREN KEN (MD)
Entity type:Individual
Prefix:
First Name:DARREN
Middle Name:KEN
Last Name:EGAMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1885 MAIN ST STE 104
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-1827
Mailing Address - Country:US
Mailing Address - Phone:808-244-7740
Mailing Address - Fax:808-244-7754
Practice Address - Street 1:1885 MAIN ST STE 104
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1827
Practice Address - Country:US
Practice Address - Phone:808-244-7740
Practice Address - Fax:808-244-7754
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD8828207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
HID222739OtherHMSA
HI08891201Medicaid
HI52305Medicare ID - Type Unspecified
HI08891201Medicaid
HI5859490001Medicare NSC