Healthcare Provider Details

I. General information

NPI: 1710089354
Provider Name (Legal Business Name): JONATHAN DAVID PALADINO M.D, PH.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2006
Last Update Date: 11/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1356 LUSITANA ST SUITE 700
HONOLULU HI
96813-2409
US

IV. Provider business mailing address

92-118 WAIKO PL SUITE 700
KAPOLEI HI
96707-3307
US

V. Phone/Fax

Practice location:
  • Phone: 808-577-0734
  • Fax:
Mailing address:
  • Phone: 412-999-8828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMD-15278
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMT189824
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: