Provider Demographics
NPI:1336477702
Name:PATRICK J. O'DONNELL, MD., LLC.
Entity Type:Organization
Organization Name:PATRICK J. O'DONNELL, MD., LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:O'DONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-983-6447
Mailing Address - Street 1:1319 PUNAHOU ST
Mailing Address - Street 2:SUITE 1120
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-1001
Mailing Address - Country:US
Mailing Address - Phone:808-983-6447
Mailing Address - Fax:808-983-8854
Practice Address - Street 1:1319 PUNAHOU ST
Practice Address - Street 2:SUITE 1120
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1001
Practice Address - Country:US
Practice Address - Phone:808-983-6447
Practice Address - Fax:808-983-8854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-24
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty