Organization
STEFANIE PARK MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEFANIE M PARK MD (OWNER)
(808) 753-1686
Entity
Organization
Contact information
Practice address
347 N KUAKINI ST, HONOLULU, HI 96817-2336
(808) 536-0300
(808) 536-0320
Mailing address
PO BOX 25490, HONOLULU, HI 96825-0490
(808) 536-0314
(808) 536-0320
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
14109
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
594300
—
HI
Enumeration date
04/25/2007
Last updated
10/11/2007
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