NPIMap

Organization Active NPI

Pan Pacific Pathologists, LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Ewa Beach, HI
National Provider Identifier
1962479360
Registry record updated Sep 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
88CL74 Issued in HI
Legal business name
PAN PACIFIC PATHOLOGISTS, LLC
Practice address
91-2135 Fort Weaver Rd
Ewa Beach, HI 96706-1929
Phone
(808) 677-7999
Fax
(808) 677-7990
NPI assigned
Mar 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Alyssa Park
Title
Ceo
Phone
(808) 680-7238

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X 88CL74 HI Primary

Addresses

Primary practice location

91-2135 Fort Weaver Rd
Ewa Beach, HI 96706-1929

Mailing address

33 Lanihuli St
Hilo, HI 96720-4142
Phone (808) 935-4814

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040318000547 HI Part B Supplier - Clinic/Group Practice 0941190474 Receives reassigned benefits from 23 practitioners
Practice locations: Hilo, HI; Wailuku, HI; Lihue, HI; Kealakekua, HI; Kahului, HI; Honolulu, HI; Aiea, HI

National Provider Directory

National Provider Directory

Locations

99-193 Aiea Heights Dr
Aiea, HI 96701
Phone (808) 679-4243

98-1079 Moanalua Rd
Fl 2
Aiea, HI 96701
Phone (808) 485-4243

550 Paiea St
Ste 210
Honolulu, HI 96819
Phone (808) 834-5120

1319 Punahou St
Bsmt
Honolulu, HI 96826
Phone (808) 983-8130

3-3420 Kuhio Hwy
Lihue, HI 96766
Phone (808) 245-1074

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 28

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220832000000",
    "number": "1962479360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 LANIHULI ST",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967204142",
            "telephone_number": "808-935-4814",
            "fax_number": "808-935-2518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-2135 FORT WEAVER RD",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967061929",
            "telephone_number": "808-677-7999",
            "fax_number": "808-677-7990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAN PACIFIC PATHOLOGISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-03",
        "last_updated": "2008-09-08",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "ALYSSA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "808-680-7238",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "HI",
            "license": "88CL74",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ewa Beach, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.