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General NPI Number Information
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NPI Number | 1235941881
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Entity Type | Organization
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Legal Business Name | EXCEL DERMATOLOGY OF HAWAII LLC
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Dates
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Enumeration Date | 01/21/2025
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 500 ALA MOANA BLVD STE 4-470
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City | HONOLULU
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State | HI
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Zip | 96813-4925
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Country | US
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Telephone | 808-495-0906
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Fax | 808-495-4849
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Provider Business Mailing Address
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Address Line | 500 ALA MOANA BLVD BLDG 4, STE 470
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City | HONOLULU
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State | HI
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Zip | 96813
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Country | US
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Telephone | 808-495-0906
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Fax | 808-495-4849
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Authorized Official
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Title or Position | OWNER
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Name | IRIS KIMHAYOUNG NOH
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Credential |
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Telephone | 808-495-0906
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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