Pacific Dermatology INC

NPI #1417101569 in Wailuku, Hawaii

Provider Information

NPI Number: 1417101569
Entity Type: Organization
Organization Name: Pacific Dermatology INC
Subpart: Yes (part of a larger organization)
Parent Organization: PACIFIC DERMATOLOGY, INC.
Primary Specialty: Dermatology
Enumeration Date: Nov 14, 2008
Last Updated: Jan 31, 2009

Practice Location

Address: 99 S MARKET ST STE 206
City: Wailuku
State: Hawaii
ZIP Code: 96793-2259
Phone: (808) 249-8600

Authorized Official

Name: JAC DANIEL MARDEN, M.D.
Title: PRESIDENT/PHYSICIAN
Phone: (808) 249-8600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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