Provider Demographics
NPI:1184937047
Name:MAKANUI, PAUL KALANI (PH D)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:KALANI
Last Name:MAKANUI
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:DR
Other - First Name:KALANI
Other - Middle Name:PAUL
Other - Last Name:MAKANUI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PH D
Mailing Address - Street 1:4760 SEPULVEDA BLVD
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-4820
Mailing Address - Country:US
Mailing Address - Phone:310-390-6612
Mailing Address - Fax:310-398-5690
Practice Address - Street 1:323 N PRAIRIE AVE
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-4502
Practice Address - Country:US
Practice Address - Phone:310-846-2100
Practice Address - Fax:310-846-2139
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY26346103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical