Organization Name: | PEDIATRIC PHYSICIANS GROUP |
NPI Number: | 1003084427 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LANCE M TANIGUCHI (MEMBER) |
Mailing Address: | 98-1238 Kaahumanu St Ste 200 Pearl City |
State: | HI US |
Postal Code: | 967823250 |
Phone Number: | 8084881990 |
Fax Number: | 8084868495 |
NPI Enumeration Date: | 02/19/2008 |
NPI Last Update Date: | 04/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | ========= |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | HI |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |