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Organization

JJTM LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SCOTT D. M. MOON M.D. (MEMBER/MANAGER)
(808) 295-5566
Entity
Organization

Contact information

Practice address
1301 PUNCHBOWL ST, HONOLULU, HI 96813-2402
(808) 547-4771
(808) 545-8577
Mailing address
102 KIIONIONI PL, HONOLULU, HI 96816-4248
(808) 295-5566
(808) 955-7426

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
7901
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
073512-05
HI
05
073512-06
HI
05
073512-07
HI
05
073512-08
HI
01
F95536(Q)
HMSA
Enumeration date
05/20/2008
Last updated
11/14/2008
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