Provider Demographics
NPI:1588772123
Name:SOON, GERALD F (MD)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:F
Last Name:SOON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1380 LUSITANA ST
Mailing Address - Street 2:SUITE 706
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2421
Mailing Address - Country:US
Mailing Address - Phone:808-521-8913
Mailing Address - Fax:808-537-3944
Practice Address - Street 1:1380 LUSITANA ST
Practice Address - Street 2:SUITE 706
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2421
Practice Address - Country:US
Practice Address - Phone:808-521-8913
Practice Address - Fax:808-537-3944
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HI3530207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH0000BDHBSMedicare ID - Type Unspecified
HIC98632Medicare UPIN