Basic Information
Provider Information
NPI: 1861687535
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PARK
FirstName: SARAH
MiddleName: Y.
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1946 YOUNG ST
Address2: SUITE 360
City: HONOLULU
State: HI
PostalCode: 968262169
CountryCode: US
TelephoneNumber: 8089737320
FaxNumber: 8089737325
Practice Location
Address1: 1319 PUNAHOU ST
Address2:  
City: HONOLULU
State: HI
PostalCode: 968261001
CountryCode: US
TelephoneNumber: 8085875876
FaxNumber: 8085876885
Other Information
ProviderEnumerationDate: 09/06/2007
LastUpdateDate: 09/06/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0208XMD-12876HIY Allopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases

No ID Information.


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