Kanayama-Trivedi, Stacy K

Kanayama-Trivedi, Stacy K is an individual health care provider with primary practice located at 480 Central Ave Department Of Family Medicine, Jbphh HI 96860-4908. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Kanayama-Trivedi, Stacy K can be contacted via phone (808) 473-1880.

Contact Information

Primary practice address
480 Central Ave Department Of Family Medicine Jbphh HI 96860-4908
Phone: (808) 473-1880
Fax: (808) 473-4411
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 202089 Louisiana

Profile Details

NPI number 1164633954
LBN Legal business name Kanayama-Trivedi, Stacy K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2007
Last updated May 20th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164633954 NPPES
Louisiana MEDICAID 1092479

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