Healthcare Provider Details

I. General information

NPI: 1336477702
Provider Name (Legal Business Name): PATRICK J. O'DONNELL, MD., LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2009
Last Update Date: 10/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1319 PUNAHOU ST SUITE 1120
HONOLULU HI
96826-1001
US

IV. Provider business mailing address

1319 PUNAHOU ST SUITE 1120
HONOLULU HI
96826-1001
US

V. Phone/Fax

Practice location:
  • Phone: 808-983-6447
  • Fax: 808-983-8854
Mailing address:
  • Phone: 808-983-6447
  • Fax: 808-983-8854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. PATRICK JOSEPH O'DONNELL
Title or Position: MANAGER
Credential: M.D.
Phone: 808-983-6447