Healthcare Provider Details

I. General information

NPI: 1760414049
Provider Name (Legal Business Name): JOEL SPENCER PECK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99-128 AIEA HEIGHTS DR STE 202
AIEA HI
96701-3932
US

IV. Provider business mailing address

590 FARRINGTON HWY # 210-307
KAPOLEI HI
96707-2009
US

V. Phone/Fax

Practice location:
  • Phone: 808-485-5855
  • Fax:
Mailing address:
  • Phone: 808-256-8800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number6247
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number6247
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: