Provider Demographics
NPI:1427360650
Name:PARDINI, MATTHEW C (LMT)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:C
Last Name:PARDINI
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 LILIHA ST
Mailing Address - Street 2:SUITE 608
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-3562
Mailing Address - Country:US
Mailing Address - Phone:808-256-7913
Mailing Address - Fax:808-734-4598
Practice Address - Street 1:1520 LILIHA ST
Practice Address - Street 2:STE 608
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-3562
Practice Address - Country:US
Practice Address - Phone:808-256-7913
Practice Address - Fax:808-734-4598
Is Sole Proprietor?:No
Enumeration Date:2010-07-02
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI10568225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist