Provider Demographics
NPI:1194949354
Name:SINE, KEALANI KANEHE (MD)
Entity type:Individual
Prefix:DR
First Name:KEALANI
Middle Name:KANEHE
Last Name:SINE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KEALANI
Other - Middle Name:KANEHE
Other - Last Name:HOLLOWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:292 HIGH SIERRA DR
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:CA
Mailing Address - Zip Code:93221
Mailing Address - Country:US
Mailing Address - Phone:559-302-7456
Mailing Address - Fax:559-592-2610
Practice Address - Street 1:216 E PINE ST
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:CA
Practice Address - Zip Code:93221-1750
Practice Address - Country:US
Practice Address - Phone:559-592-2600
Practice Address - Fax:559-592-2610
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA61936208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A61936Medicaid
G72026Medicare UPIN
CA00A61936Medicare ID - Type Unspecified