Healthcare Provider Details

I. General information

NPI: 1053654152
Provider Name (Legal Business Name): MEREDITH KL PANG, M.D., INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2013
Last Update Date: 03/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1834 NUUANU AVE
HONOLULU HI
96817-2427
US

IV. Provider business mailing address

1834 NUUANU AVE
HONOLULU HI
96817-2427
US

V. Phone/Fax

Practice location:
  • Phone: 808-537-2932
  • Fax: 808-537-2933
Mailing address:
  • Phone: 808-537-2932
  • Fax: 808-537-2933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number1966
License Number StateHI

VIII. Authorized Official

Name: DR. MEREDITH PANG
Title or Position: PRESIDENT
Credential:
Phone: 808-537-2932