Provider Demographics
NPI:1649423641
Name:PAK, HERMANN
Entity Type:Individual
Prefix:MR
First Name:HERMANN
Middle Name:
Last Name:PAK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 HOBRON LANE
Mailing Address - Street 2:APT. #1708
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815
Mailing Address - Country:US
Mailing Address - Phone:808-230-9117
Mailing Address - Fax:
Practice Address - Street 1:411 HOBRON LN
Practice Address - Street 2:APT.# 1708
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-1228
Practice Address - Country:US
Practice Address - Phone:808-942-5626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist