Healthcare Provider Details

I. General information

NPI: 1740108216
Provider Name (Legal Business Name): VERONICA PAK TAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3465 WAIALAE AVE STE 240
HONOLULU HI
96816-2664
US

IV. Provider business mailing address

3465 WAIALAE AVE STE 240
HONOLULU HI
96816-2664
US

V. Phone/Fax

Practice location:
  • Phone: 808-522-2285
  • Fax: 808-734-2664
Mailing address:
  • Phone: 808-522-2285
  • Fax: 808-734-2664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLSW-3259
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: