Healthcare Provider Details

I. General information

NPI: 1992182570
Provider Name (Legal Business Name): CHRISTINA VIGGIANO MARZO MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2015
Last Update Date: 09/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 N KUAKINI ST
HONOLULU HI
96817
US

IV. Provider business mailing address

405 N KUAKINI ST
HONOLULU HI
96817-6300
US

V. Phone/Fax

Practice location:
  • Phone: 808-536-2236
  • Fax:
Mailing address:
  • Phone: 808-536-2236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number19842
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: