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General NPI Number Information
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NPI Number | 1083925580
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Entity Type | Organization
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Legal Business Name | DEREK K H PANG MD INC
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Dates
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Enumeration Date | 06/30/2010
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Last Update Date | 12/09/2011
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Provider Practice Location Address
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Address Line | 2228 LILIHA ST 401
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City | HONOLULU
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State | HI
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Zip | 96817-1650
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Country | US
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Telephone | 808-523-1343
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Fax | 808-523-1345
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Provider Business Mailing Address
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Address Line | 2228 LILIHA ST 401
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City | HONOLULU
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State | HI
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Zip | 96817-1650
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Country | US
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Telephone | 808-523-1343
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Fax | 808-523-1345
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Authorized Official
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Title or Position | MEDICAL ASSISTANT
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Name | MS. LILIBETH DOMINGO CATO
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Credential |
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Telephone | 808-523-1343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 3734
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License Number State | HI
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