Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | MD7721 | HI |
NPI | 1063524007 |
---|---|
Provider Name | Darryl M Kan |
First Address | Honolulu, HI 96813-2421 |
Second Address | Honolulu, HI 96813-2421 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
07195002 | (05) | HI |
F17752 | (02) | HI |