Provider Demographics
NPI:1770918757
Name:E MALAMA KAKOU FAMILY PRACTICE
Entity type:Organization
Organization Name:E MALAMA KAKOU FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRIMARY CARE PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HIRAKAMI
Authorized Official - Suffix:
Authorized Official - Credentials:APRNRX
Authorized Official - Phone:808-339-7093
Mailing Address - Street 1:PO BOX 8712, 153014 PAHOA VILLAGE ROAD
Mailing Address - Street 2:152662 PAHOA VILLAGE ROAD SUITE 306
Mailing Address - City:PAHOA
Mailing Address - State:HI
Mailing Address - Zip Code:96778
Mailing Address - Country:US
Mailing Address - Phone:808-339-7076
Mailing Address - Fax:808-339-7093
Practice Address - Street 1:153014 PAHOA VILLAGE ROAD
Practice Address - Street 2:
Practice Address - City:PAHOA
Practice Address - State:HI
Practice Address - Zip Code:96778
Practice Address - Country:US
Practice Address - Phone:808-339-7093
Practice Address - Fax:808-339-7076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-09
Last Update Date:2014-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI979261QP2300X
HI891261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care