Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 3477 | HI |
NPI | 1043307754 |
---|---|
Provider Name | Dr. Glenn Mun Lok Pang |
First Address | Honolulu, HI 96817 |
Second Address | Honolulu, HI 96817 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01071301 | (05) | HI |
D36217 | (02) |