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General NPI Number Information
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NPI Number | 1134112840
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Entity Type | Organization
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Legal Business Name | PACIFIC EYE SURGERY CENTER, INC.
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Dates
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Enumeration Date | 08/26/2005
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Last Update Date | 02/20/2008
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Provider Practice Location Address
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Address Line | 2055 N KING ST SUITE 100
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City | HONOLULU
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State | HI
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Zip | 96819-3479
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Country | US
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Telephone | 808-533-7400
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Fax | 808-521-7798
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Provider Business Mailing Address
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Address Line | 2055 N KING ST SUITE 100
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City | HONOLULU
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State | HI
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Zip | 96819-3479
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Country | US
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Telephone | 808-533-7400
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Fax | 808-521-7798
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Authorized Official
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Title or Position | PRESIDENT
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Name | M. PIERRE PANG
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Credential | M.D.
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Telephone | 808-533-7400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number | MD 5296
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License Number State | HI
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