Provider Demographics
NPI:1730138827
Name:ZEN, MARK K K (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:K K
Last Name:ZEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 62179
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96839-2179
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1345 S BERETANIA STREET
Practice Address - Street 2:SUITE 302
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1802
Practice Address - Country:US
Practice Address - Phone:808-591-6599
Practice Address - Fax:808-591-6075
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI48572084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIE01187Medicare UPIN
0000BDKRRMedicare ID - Type Unspecified