Provider Demographics
NPI:1619033313
Name:ROY O KAMADA MD INC
Entity type:Organization
Organization Name:ROY O KAMADA MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:O
Authorized Official - Last Name:KAMADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-521-9154
Mailing Address - Street 1:405 N KUAKINI ST
Mailing Address - Street 2:SUITE1107
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-6300
Mailing Address - Country:US
Mailing Address - Phone:808-521-9154
Mailing Address - Fax:808-521-9170
Practice Address - Street 1:405 N KUAKINI ST
Practice Address - Street 2:SUITE1107
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-6300
Practice Address - Country:US
Practice Address - Phone:808-521-9154
Practice Address - Fax:808-521-9170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1678207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI03137101Medicaid
=========OtherTAX ID NUMBER
0000BDRRBMedicare ID - Type UnspecifiedMEDICARE NUMBER
HI03137101Medicaid