Provider Demographics
NPI:1083148209
Name:LYONS CARE ASSOCIATES, LLC
Entity type:Organization
Organization Name:LYONS CARE ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KANANI
Authorized Official - Middle Name:
Authorized Official - Last Name:PALAKIKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-866-5333
Mailing Address - Street 1:1830 WELLS ST
Mailing Address - Street 2:STE: 103
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-2365
Mailing Address - Country:US
Mailing Address - Phone:808-866-5335
Mailing Address - Fax:808-866-5330
Practice Address - Street 1:1830 WELLS ST
Practice Address - Street 2:STE: 103
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-2365
Practice Address - Country:US
Practice Address - Phone:808-866-5335
Practice Address - Fax:808-866-5330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD6373208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIE72783Medicare UPIN
HIH0000BDRXGMedicare PIN