Healthcare Provider Details
I. General information
NPI: 1083856439
Provider Name (Legal Business Name): JASON LEE PIRGA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/01/2009
Last Update Date: 02/02/2022
Certification Date: 02/02/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
888 S KING ST
HONOLULU HI
96813-3097
US
IV. Provider business mailing address
PO BOX 8436
HONOLULU HI
96830-0436
US
V. Phone/Fax
- Phone: 808-522-4000
- Fax: 808-522-4277
- Phone: 808-522-4000
- Fax: 808-522-4277
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | MD-16519 |
| License Number State | HI |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | MD-16519 |
| License Number State | HI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: