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NPI Code Detail

MEDICARE: DR. MARK NICHOLAS FLANAGAN DO

MEDICARE: DR. MARK NICHOLAS FLANAGAN DO
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 PhysicianDOS-2253HI

General Provider Information

NPI Number : 1679559132
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK NICHOLAS FLANAGAN DO
Provider Business Mailing Address
First Line : PO BOX 740241
Second Line :
City : LOS ANGELES
State : CA
Zip : 90074-0241
Country : US
Telephone Number : 808-522-4000
Fax Number : 808-522-4062
Provider Business Practice Location Address
First Line : 888 S KING ST
Second Line :
City : HONOLULU
State : HI
Zip : 96813-3097
Country : US
Telephone Number : 808-522-4000
Fax Number : 808-522-4062
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2005
Last Update Date : 01/06/2025

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