Basic Information
Provider Information
NPI: 1306874094
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KAM
FirstName: CALVIN
MiddleName: C.M.
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 29640
Address2:  
City: HONOLULU
State: HI
PostalCode: 968202040
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1301 PUNCHBOWL ST
Address2:  
City: HONOLULU
State: HI
PostalCode: 968132402
CountryCode: US
TelephoneNumber: 8085389011
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/29/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207T00000XMD1370HIY Allopathic & Osteopathic PhysiciansNeurological Surgery 

No ID Information.


Home