Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Wailea Medical Group LLC

Organization Internal Medicine Physician · NPI 1497769988

Wailea Medical Group LLC is an Internal Medicine Physician in Wailea, Hawaii. Licensed in Hawaii. Registered with an NPI since 2006.

Licensed in
HI
In the registry since
2006
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

161 Wailea Ike Pl #B102
Wailea, HI 96753-6521
Phone: (808) 875-9095
Fax: (808) 875-9098
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 3915 (HI)

Record details

NPI number1497769988
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gregory Park — M.D. · (808) 875-9095
NPI enumeratedJuly 28, 2006
Last updated in NPPESSeptember 16, 2015
Mailing address161 Wailea Ike Pl, B-102, Wailea, HI 96753-6521

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