Healthcare Provider Details

I. General information

NPI: 1154866473
Provider Name (Legal Business Name): GOLDEN DERMATOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2016
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2226 LILIHA ST STE 302
HONOLULU HI
96817-1605
US

IV. Provider business mailing address

2226 LILIHA ST STE 302
HONOLULU HI
96817-1605
US

V. Phone/Fax

Practice location:
  • Phone: 808-585-8008
  • Fax:
Mailing address:
  • Phone: 808-585-8008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: SPRING K GOLDEN
Title or Position: OWNER
Credential: MD
Phone: 808-585-8008