Active NPI
Pacific Dermatology Inc
- Dermatology Physician
- Wailuku, HI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- Legal business name
- PACIFIC DERMATOLOGY INC
- Practice address
- 99 S Market St Ste 206
Wailuku, HI 96793-2259 - Phone
- (808) 249-8600
- NPI assigned
- Nov 14, 2008
- Last updated
- Jan 31, 2009
- Organization subpart
- Yes
- Parent organization
- PACIFIC DERMATOLOGY, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jac Daniel Marden, M.D.
- Title
- President/Physician
- Phone
- (808) 249-8600
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | NU | Primary |
Addresses
Primary practice location
99 S Market St Ste 206
Wailuku, HI 96793-2259
Mailing address
99 S Market St Ste 206
Wailuku, HI 96793-2259
Phone (808) 249-8600
National Provider Directory
National Provider Directory- Part of
- Pacific Dermatology Inc
Locations
99 S Market St
Ste 206
Wailuku, HI 96793
Phone (808) 244-4887
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Dermatology Physician
- Wailuku, HI
- NPI 1548250277
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226620800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1233360000000",
"number": "1417101569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 S MARKET ST STE 206",
"city": "WAILUKU",
"state": "HI",
"postal_code": "967932259",
"telephone_number": "808-249-8600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99 S MARKET ST STE 206",
"city": "WAILUKU",
"state": "HI",
"postal_code": "967932259",
"telephone_number": "808-249-8600"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PACIFIC DERMATOLOGY INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PACIFIC DERMATOLOGY, INC.",
"enumeration_date": "2008-11-14",
"last_updated": "2009-01-31",
"status": "A",
"authorized_official_last_name": "MARDEN",
"authorized_official_first_name": "JAC",
"authorized_official_middle_name": "DANIEL",
"authorized_official_title_or_position": "PRESIDENT/PHYSICIAN",
"authorized_official_telephone_number": "808-249-8600",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wailuku, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.