Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | G84261 | CA |
N | 208000000X | Pediatrician | MD-11054 | HI |
N | 2080P0208X | Pediatric Infectious Diseases | G84261 | CA |
N | 2080P0208X | Pediatric Infectious Diseases | MD-11054 | HI |
NPI | 1225120769 |
---|---|
Provider Name | Dr. Douglas Kwock |
First Address | Honolulu, HI 96826 |
Second Address | Honolulu, HI 96826 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
22935-1 | HMSA (01) | HI |
22935-1 | QUEST (01) | HI |
53722701 | (05) | HI |
G32869 | (02) | HI |