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General NPI Number Information
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NPI Number | 1790840718
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Entity Type | Organization
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Legal Business Name | DONNA JEAN MAH MD INC
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 07/11/2014
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Provider Practice Location Address
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Address Line | 1314 S KING ST SUITE 414
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City | HONOLULU
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State | HI
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Zip | 96814
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Country | US
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Telephone | 808-593-8686
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Fax | 808-597-1288
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Provider Business Mailing Address
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Address Line | 1314 S KING ST SUITE 414
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City | HONOLULU
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State | HI
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Zip | 96814
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Country | US
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Telephone | 808-593-8686
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Fax | 808-597-1288
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DONNA JEAN MAH
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Credential | MD
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Telephone | 808-593-8686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD 1003
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD 7068
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License Number State | HI
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