Healthcare Provider Details

I. General information

NPI: 1023579158
Provider Name (Legal Business Name): FLORENCE KAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2019
Last Update Date: 06/27/2023
Certification Date: 06/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 S BERETANIA ST STE 300
HONOLULU HI
96813-2423
US

IV. Provider business mailing address

550 S BERETANIA ST STE 300
HONOLULU HI
96813-2423
US

V. Phone/Fax

Practice location:
  • Phone: 808-686-4620
  • Fax:
Mailing address:
  • Phone: 808-686-4620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD-22413
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD-22413
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: