| Tanner Kim, MD | |
| 1301 Punchbowl St, Honolulu, HI 96813-2499 | |
| (808) 691-1000 | |
| Not Available | 
| Full Name | Tanner Kim | 
|---|---|
| Gender | Male | 
| Speciality | Surgery - Vascular Surgery | 
| Location | 1301 Punchbowl St, Honolulu, Hawaii | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1154778249 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 2086S0129X | Surgery - Vascular Surgery | MD-22626 (Hawaii) | Primary | 
| Entity Name | The Queens Medical Center | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1487693586 PECOS PAC ID: 3476454067 Enrollment ID: O20040116000366 | 
| Entity Name | Queens North Hawaii Community Hospital | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1528049814 PECOS PAC ID: 0143116293 Enrollment ID: O20040225000562 | 
| Entity Name | Queens University Medical Group | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1891441382 PECOS PAC ID: 2466831557 Enrollment ID: O20220621000534 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Tanner Kim, MD 1301 Punchbowl St, Honolulu, HI 96813-2499 Ph: (808) 691-1000 | Tanner Kim, MD 1301 Punchbowl St, Honolulu, HI 96813-2499 Ph: (808) 691-1000 | 
| Jessica Green,  Surgery Medicare: Accepting Medicare Assignments Practice Location: 888 S King St, Honolulu, HI 96813 Phone: 808-522-4469 | |
| Dr. Justin M. Galovich, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 3288 Moanalua Rd, Honolulu, HI 96819 Phone: 808-432-0000 | |
| Dr. Cedric San Felipe Lorenzo, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1329 Lusitana St Ste 304, Honolulu, HI 96813 Phone: 808-566-6723 | |
| Dr. Elna M. Masuda, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 888 S King St, Honolulu, HI 96813 Phone: 808-522-4000 Fax: 808-522-4523 | |
| Dr. Aaliyah Sevier-grogan, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 1356 Lusitana St Fl 6, Honolulu, HI 96813 Phone: 808-691-1000 | |
| Dr. Patrick Paul Pedro, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 550 S Beretania St, Suite #501, Honolulu, HI 96813 Phone: 808-528-4144 Fax: 808-525-6868 | |
| Dr. Peter Halford, MD Surgery Medicare: Medicare Enrolled Practice Location: 1329 Lusitana, 706, Honolulu, HI 96813 Phone: 808-536-1107 Fax: 808-536-2931 |