Individual
ELLECIA COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
110 E KAAHUMANU AVE, KAHULUI, HI 96732-2118
(808) 871-1730
(808) 984-7444
Mailing address
2180 MAIN ST, WAILUKU, HI 96793-1625
(808) 242-6464
(808) 242-4292
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
DOS-1520
HI
208D00000X
General Practice Physician
UO2227
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HM482Z
MEDICARE ID
HI
Enumeration date
09/08/2009
Last updated
03/14/2019
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