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NPI Code Detail

MEDICARE: DR. MIN CHAI KENNETH PAK MD

MEDICARE: DR. MIN CHAI KENNETH PAK MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine PhysicianMD-13241HI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598718108
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MIN CHAI KENNETH PAK MD
Provider Business Mailing Address
First Line : 200 CORPORATE BLVD
Second Line : SUITE 201
City : LAFAYETTE
State : LA
Zip : 70508-3870
Country : US
Telephone Number : 800-893-9698
Fax Number :
Provider Business Practice Location Address
First Line : 91-2141 FORT WEAVER RD
Second Line :
City : EWA BEACH
State : HI
Zip : 96706-1993
Country : US
Telephone Number : 626-564-8457
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2006
Last Update Date : 07/08/2007

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