| |
1451 S King St, Suite 402, Honolulu, HI 96814-2506 | |
(808) 941-7799 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Nurse Practitioner - Family |
Location | 1451 S King St, Honolulu, Hawaii |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1235574419 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
171100000X | Acupuncturist | 1044 (Hawaii) | Secondary |
363LF0000X | Nurse Practitioner - Family | 1042 (Hawaii) | Primary |
Provider Name | Mary I Jang |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073800157 PECOS PAC ID: 2668763822 Enrollment ID: I20160622002153 |
Mailing Address | Practice Location Address |
---|---|
1451 S King St, Suite 402, Honolulu, HI 96814-2506 Ph: (808) 941-7799 | 1451 S King St, Suite 402, Honolulu, HI 96814-2506 Ph: (808) 941-7799 |