Provider Demographics
NPI:1033082920
Name:MALAMA CARE LLC
Entity type:Organization
Organization Name:MALAMA CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:R
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:917-582-2356
Mailing Address - Street 1:91-1007 WAIILIKAHI ST
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-6407
Mailing Address - Country:US
Mailing Address - Phone:917-582-2356
Mailing Address - Fax:808-207-2553
Practice Address - Street 1:91-1007 WAIILIKAHI ST
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-6407
Practice Address - Country:US
Practice Address - Phone:917-582-2356
Practice Address - Fax:808-207-2553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-26
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty