Healthcare Provider Details

I. General information

NPI: 1265696116
Provider Name (Legal Business Name): JASON BROWN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 07/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1575 S BERETANIA ST STE 201-202 HAWAII ANESTHESIA GROUP
HONOLULU HI
96826-1141
US

IV. Provider business mailing address

1575 S BERETANIA ST STE 201-202 HAWAII ANESTHESIA GROUP
HONOLULU HI
96826-1141
US

V. Phone/Fax

Practice location:
  • Phone: 808-218-4332
  • Fax:
Mailing address:
  • Phone: 808-218-4332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number16799
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number239734
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number246253
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: