Healthcare Provider Details

I. General information

NPI: 1851573273
Provider Name (Legal Business Name): VALDEN MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2007
Last Update Date: 11/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 KALAKAUA AVE SUITE 2602
HONOLULU HI
96826-3766
US

IV. Provider business mailing address

1750 KALAKAUA AVE SUITE 2602
HONOLULU HI
96826-3766
US

V. Phone/Fax

Practice location:
  • Phone: 808-949-4977
  • Fax:
Mailing address:
  • Phone: 808-949-4977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4624
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2779
License Number StateHI

VIII. Authorized Official

Name: MR. MATTHEW MEE-LEE
Title or Position: PRESIDENT
Credential: J.D.
Phone: 808-457-1800