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General NPI Number Information
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NPI Number | 1982420907
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Entity Type | Organization
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Legal Business Name | HAWAII SURGERY LLC
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Dates
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Enumeration Date | 11/25/2024
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 321 N KUAKINI ST STE 714
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City | HONOLULU
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State | HI
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Zip | 96817-2362
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Country | US
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Telephone | 808-528-3606
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Fax | 808-538-7850
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Provider Business Mailing Address
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Address Line | 321 N KUAKINI ST STE 714
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City | HONOLULU
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State | HI
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Zip | 96817-2362
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Country | US
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Telephone | 808-528-3606
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Fax | 808-538-7850
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Authorized Official
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Title or Position | MD OWNER
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Name | CHAN PARK
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Credential | MD
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Telephone | 919-448-6843
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology 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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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