Provider Demographics
NPI:1235728494
Name:GOZUN, MAAN KATHRYN LAQUINDANUM (MD)
Entity Type:Individual
Prefix:
First Name:MAAN KATHRYN
Middle Name:LAQUINDANUM
Last Name:GOZUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MAAN KATHRYN
Other - Middle Name:SANTOS
Other - Last Name:LAQUINDANUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1356 LUSITANA ST FL 7
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2409
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1356 LUSITANA ST FL 7
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2409
Practice Address - Country:US
Practice Address - Phone:808-586-2898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI8032207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine