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Organization
WAILEA MEDICAL GROUP LLC
Active
Organization
WAILEA MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY L PARK MD (M.D.)
(808) 875-9095
Entity
Organization
Contact information
Practice address
161 WAILEA IKE PL, #B102, WAILEA, HI 96753-6521
(808) 875-9095
(808) 875-9098
Mailing address
161 WAILEA IKE PL, B-102, WAILEA, HI 96753-6521
(808) 875-9095
(808) 875-9098
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
3915
HI
Other
Enumeration date
07/28/2006
Last updated
09/16/2015
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