Healthcare Provider Details

I. General information

NPI: 1487654794
Provider Name (Legal Business Name): M PIERRE PANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 10/28/2021
Certification Date: 10/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 N KING ST #100
HONOLULU HI
96819-3479
US

IV. Provider business mailing address

2228 LILIHA ST STE 102A
HONOLULU HI
96817-1651
US

V. Phone/Fax

Practice location:
  • Phone: 808-533-7400
  • Fax: 808-521-7798
Mailing address:
  • Phone: 808-533-7400
  • Fax: 808-521-7798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD5296
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: