Organization
PACIFIC DERMATOLOGY INC
Active
Parent organization
PACIFIC DERMATOLOGY, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
PACIFIC DERMATOLOGY, INC.
Authorized official
JAC DANIEL MARDEN M.D. (PRESIDENT/PHYSICIAN)
(808) 249-8600
Entity
Organization
Contact information
Practice address
99 S MARKET ST STE 206, WAILUKU, HI 96793-2259
(808) 249-8600
Mailing address
99 S MARKET ST STE 206, WAILUKU, HI 96793-2259
(808) 249-8600
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
11/14/2008
Last updated
01/31/2009
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