Provider Demographics
NPI:1992915086
Name:PLASTIC SURGERY CTR OF THE PAC INC
Entity type:Organization
Organization Name:PLASTIC SURGERY CTR OF THE PAC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:FLOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-521-1999
Mailing Address - Street 1:677 ALA MOANA BLVD STE 1011
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-5471
Mailing Address - Country:US
Mailing Address - Phone:808-521-1999
Mailing Address - Fax:
Practice Address - Street 1:677 ALA MOANA BLVD STE 1011
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-5471
Practice Address - Country:US
Practice Address - Phone:808-521-1999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1709261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical