Healthcare Provider Details

I. General information

NPI: 1962479360
Provider Name (Legal Business Name): PAN PACIFIC PATHOLOGISTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2006
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99-193 AIEA HEIGHTS DR
AIEA HI
96701-3911
US

IV. Provider business mailing address

33 LANIHULI ST
HILO HI
96720-4142
US

V. Phone/Fax

Practice location:
  • Phone: 808-834-5160
  • Fax: 808-679-4230
Mailing address:
  • Phone: 808-935-4814
  • Fax: 808-935-2518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number88CL74
License Number StateHI

VIII. Authorized Official

Name: MRS. MICHELE COX
Title or Position: PRESIDENT
Credential:
Phone: 808-679-4225