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General NPI Number Information
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NPI Number | 1972893980
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Entity Type | Organization
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Legal Business Name | PATTI K M ENDO MD INC
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Dates
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Enumeration Date | 04/11/2011
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Last Update Date | 04/11/2011
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Provider Practice Location Address
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Address Line | 135 S WAKEA AVE SUITE 111
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City | KAHULUI
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State | HI
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Zip | 96732-1385
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Country | US
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Telephone | 808-877-3635
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Fax | 808-877-4363
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Provider Business Mailing Address
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Address Line | 135 S WAKEA AVE SUITE 111
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City | KAHULUI
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State | HI
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Zip | 96732-1385
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Country | US
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Telephone | 808-877-3635
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Fax | 808-877-4363
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PATTI K ENDO
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Credential | M.D.
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Telephone | 808-877-3635
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MD9088
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License Number State | HI
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