Healthcare Provider Details

I. General information

NPI: 1447252473
Provider Name (Legal Business Name): LUCIO U PASCUA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86-260 FARRINGTON HWY
WAIANAE HI
96792-3128
US

IV. Provider business mailing address

86-260 FARRINGTON HWY
WAIANAE HI
96792-3128
US

V. Phone/Fax

Practice location:
  • Phone: 808-697-3300
  • Fax: 808-697-3347
Mailing address:
  • Phone: 808-697-3300
  • Fax: 808-697-3347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD9705
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: