Healthcare Provider Details

I. General information

NPI: 1629786868
Provider Name (Legal Business Name): MARIA PATTEN D.O., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2022
Last Update Date: 11/07/2022
Certification Date: 11/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1188 BISHOP ST STE 3306
HONOLULU HI
96813-3313
US

IV. Provider business mailing address

PO BOX 6
KAILUA HI
96734-0006
US

V. Phone/Fax

Practice location:
  • Phone: 808-282-0907
  • Fax: 808-356-0963
Mailing address:
  • Phone: 808-284-4800
  • Fax: 808-356-0963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081N0008X
TaxonomyNeuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARIA B PATTEN
Title or Position: PRESIDENT/OWNER
Credential: DO
Phone: 808-284-4800