| Mahalo Doctor Llc | |
|
1301 Punchbowl St Honolulu HI 96813-2402 | |
| (415) 314-0699 | |
| Not Available |
| Full Name | Mahalo Doctor Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1301 Punchbowl St, Honolulu, Hawaii |
| Authorized Official Name and Position | Mary Lan (OWNER) |
| Authorized Official Contact | 4153140699 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mahalo Doctor Llc Po Box 5046 Kaneohe HI 96744-9046 Ph: (415) 314-0699 | Mahalo Doctor Llc 1301 Punchbowl St Honolulu HI 96813-2402 Ph: (415) 314-0699 |
| NPI Number | 1013764208 |
|---|---|
| Provider Enumeration Date | 05/04/2024 |
| Last Update Date | 05/04/2024 |
| Medicare PECOS PAC ID | 3375088636 |
|---|---|
| Medicare Enrollment ID | O20240710004442 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013764208 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Mary Lan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245681337 PECOS PAC ID: 4082989603 Enrollment ID: I20240718004827 |
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