Healthcare Provider Details

I. General information

NPI: 1548173370
Provider Name (Legal Business Name): ALASTAIR ADRIAN PAN PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 SOUTH ST APT 2005
HONOLULU HI
96813-6215
US

IV. Provider business mailing address

555 SOUTH ST APT 2005
HONOLULU HI
96813-6215
US

V. Phone/Fax

Practice location:
  • Phone: 808-383-0069
  • Fax:
Mailing address:
  • Phone: 808-383-0069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: