Organization
OUTREACH MEDICAL GROUP DOWNTOWN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEREK M TENGAN PHARM.D. (MEMBER)
(808) 845-5550
Entity
Organization
Contact information
Practice address
928 NUUANU AVE # 1-C, HONOLULU, HI 96817-5190
(808) 845-5550
(808) 845-5557
Mailing address
94-449 AKOKI ST STE 104, WAIPAHU, HI 96797-2732
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/15/2022
Last updated
08/02/2023
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