# MAHALO DOCTOR LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013764208
- **Authorized official:** MARY LAN MD (OWNER)
- **Authorized official phone:** (415) 314-0699

## Contact information

- **Practice address:** 1301 PUNCHBOWL ST, HONOLULU, HI 96813-2402
- **Practice address phone:** (415) 314-0699
- **Mailing address:** PO BOX 5046, KANEOHE, HI 96744-9046
- **Mailing address phone:** (415) 314-0699

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/04/2024
- **Last updated:** 05/04/2024