Healthcare Provider Details

I. General information

NPI: 1417121757
Provider Name (Legal Business Name): MARCO RIZZO MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2008
Last Update Date: 04/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 LUSITANA ST SUITE 401
HONOLULU HI
96813
US

IV. Provider business mailing address

1329 LUSITANA ST SUITE 401
HONOLULU HI
96813
US

V. Phone/Fax

Practice location:
  • Phone: 808-533-2900
  • Fax: 808-531-8991
Mailing address:
  • Phone: 808-533-2900
  • Fax: 808-531-8991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberMD2392
License Number StateHI

VIII. Authorized Official

Name: DR. MARCO RIZZO
Title or Position: PRESIDENT
Credential: MD
Phone: 808-533-2900