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SUNNYSIDE MEDICAL CLINIC LLC
NPI 1407362395
Clinic/Center - Primary Care in Kailua, HI

Active since December 14, 2017
1005 KEOLU DR STE A, KAILUA, HI 96734(808) 727-1715 Get Directions Write a Review

NPPES record last updated: December 12, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 12, 2019, Dec 14, 2017 (2 updates tracked since 2017).

About Sunnyside Medical Clinic Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUNNYSIDE MEDICAL CLINIC LLC (NPI 1407362395) is a healthcare organization registered as a primary care in Kailua, Hawaii and active in the NPI registry since December 2017. The organization maintains a secondary practice location in Waianae and lists Michelle Shanks, Owner, as its authorized official.

NPPES Registry Identity

NPI1407362395
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameSUNNYSIDE MEDICAL CLINIC LLC
Location Address1005 KEOLU DR STE AKailua, HI 96734-3873
Mailing Address84-740 Kili Dr, 427Waianae, HI 96792-1509 · (808) 825-0190
Phone(808) 727-1715
Organization SubpartNo
Authorized OfficialMichelle ShanksOwner · (808) 825-0190
Enumeration DateDecember 14, 2017
Last NPPES UpdateDecember 12, 20192 updates tracked since enumeration
✔ NPI 1407362395 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
Also ListedClinic/CenterTaxonomy 261Q00000X
Also ListedClinic/Center · Health ServiceTaxonomy 261QH0100X
1005 KEOLU DR STE A, Kailua, HI 96734
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Secondary Practice Location 1

Location 184-740 Kili DrWaianae, HI 96792-1509 · Phone (808) 825-0190

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHELLE L SHANKS ARNP-C
Nurse Practitioner (Adult Health)
1005 KEOLU DR STE A
KAILUA, HI 96734
Honolulu County (808) 727-1715
KAILUA SPINE CENTER LLC
Clinic/Center
1005 KEOLU DR STE A
KAILUA, HI 96734
Honolulu County (218) 390-5431

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sunnyside Medical Clinic LLC's NPI number?

The NPI number for Sunnyside Medical Clinic LLC is 1407362395. It was assigned to this organization in the NPPES registry on December 14, 2017.

Where is Sunnyside Medical Clinic LLC located?

Sunnyside Medical Clinic LLC is located at 1005 Keolu Dr Ste A, Kailua, HI 96734. The listed phone number is (808) 727-1715.

What is Sunnyside Medical Clinic LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

When was this NPI record last updated?

The NPPES record for Sunnyside Medical Clinic LLC was last updated on December 12, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.