Provider Demographics
NPI:1235979659
Name:HAWAII KAI HEALTH CARE LLC
Entity type:Organization
Organization Name:HAWAII KAI HEALTH CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:NORDYKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-751-7193
Mailing Address - Street 1:6700 KALANIANAOLE HWY STE 106
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-1278
Mailing Address - Country:US
Mailing Address - Phone:808-751-7193
Mailing Address - Fax:808-451-2060
Practice Address - Street 1:6700 KALANIANAOLE HWY STE 106
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-1278
Practice Address - Country:US
Practice Address - Phone:808-751-7193
Practice Address - Fax:808-451-2060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-31
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty