Provider Demographics
NPI:1912057100
Name:HONOLULU PAIN MANAGEMENT CLINIC, L.L.C.
Entity type:Organization
Organization Name:HONOLULU PAIN MANAGEMENT CLINIC, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:SZE-CHUNG
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-528-3657
Mailing Address - Street 1:500 ALA MOANA BLVD STE 1-302
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-4920
Mailing Address - Country:US
Mailing Address - Phone:808-528-3657
Mailing Address - Fax:808-524-6552
Practice Address - Street 1:500 ALA MOANA BLVD STE 1-302
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-4920
Practice Address - Country:US
Practice Address - Phone:808-528-3657
Practice Address - Fax:808-524-6552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD7531207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty