Provider Demographics
NPI:1528190741
Name:TIM SING, PATRICE M L (MD)
Entity Type:Individual
Prefix:
First Name:PATRICE
Middle Name:M L
Last Name:TIM SING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 KALANIANAOLE HWY STE 111
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-1278
Mailing Address - Country:US
Mailing Address - Phone:808-432-3700
Mailing Address - Fax:
Practice Address - Street 1:6700 KALANIANAOLE HWY STE 111
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-1278
Practice Address - Country:US
Practice Address - Phone:808-432-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-9931207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00A0223204OtherHMSA BILLING NUMBER
HI089154-03Medicaid
HI089154-03Medicaid