Individual
PANTEA SHOJA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1860 ALA MOANA BLVD, #101, HONOLULU, HI 96815-1632
(808) 921-2273
(808) 921-2274
Mailing address
1245 KUALA ST, SUITE 103, PEARL CITY, HI 96782-3900
(808) 456-2273
(808) 456-2274
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17011
HI
207Q00000X
Family Medicine Physician
R70149
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R70149
TRAINING PERMIT
AZ
Enumeration date
08/27/2008
Last updated
10/19/2016
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