Basic Information
| Provider Information | |||||||||
| NPI: | 1447437413 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PACIFIC EMERGENCY PHYSICIANS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2230 LILIHA STREET | ||||||||
| Address2: | HAWAII MEDICAL CENTER EAST EMERGENCY DEPT | ||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 96817 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8085476387 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2230 LILIHA ST | ||||||||
| Address2: | HAWAII MEDICAL CENTER EAST EMERGENCY DEPT | ||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968171646 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8085476387 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/22/2008 | ||||||||
| LastUpdateDate: | 01/22/2008 | ||||||||
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| AuthorizedOfficialLastName: | KELLY | ||||||||
| AuthorizedOfficialFirstName: | MELANIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8085476387 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.