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Organization

DAWSON DERMATOLOGY, LLC

Active
Other names
Dawson Dermatology
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KEVIN L DAWSON M.D. (OWNER/SOLE MEMBER)
(808) 599-3780
Entity
Organization

Contact information

Practice address
1380 LUSITANA ST, SUITE 412, HONOLULU, HI 96813-2421
(808) 599-3780
(808) 538-1672
Mailing address
1380 LUSITANA ST, SUITE 412, HONOLULU, HI 96813-2421
(808) 599-3780
(808) 538-1672

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD12990
HI
174400000X
Specialist
MD1577
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00B0247375
HMSA PROV # - K DAWSON
HI
01
00C0034110
HMSA PROV # - A IZUMI
HI
01
12D0620093
CLIA NUMBER
HI
05
5533560
HI
Enumeration date
12/08/2006
Last updated
11/07/2013
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