Provider Demographics
NPI:1306967468
Name:PSYCHIATRIC ASSOCIATES LTD
Entity type:Organization
Organization Name:PSYCHIATRIC ASSOCIATES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NAOMI
Authorized Official - Middle Name:S
Authorized Official - Last Name:KEMBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-537-2665
Mailing Address - Street 1:600 KAPIOLANI BLVD STE 402
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-5141
Mailing Address - Country:US
Mailing Address - Phone:808-537-2665
Mailing Address - Fax:
Practice Address - Street 1:600 KAPIOLANI BLVD STE 402
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-5141
Practice Address - Country:US
Practice Address - Phone:808-537-2665
Practice Address - Fax:808-524-3747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI079892Medicaid
HIHPALMedicare PIN