Provider Demographics
NPI:1851593420
Name:G. TODD BESSINGER, MD, PHD, LLC
Entity Type:Organization
Organization Name:G. TODD BESSINGER, MD, PHD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER, LLC
Authorized Official - Prefix:DR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:BESSINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:808-218-7889
Mailing Address - Street 1:1029 KAPAHULU AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-1305
Mailing Address - Country:US
Mailing Address - Phone:808-218-7889
Mailing Address - Fax:808-218-7981
Practice Address - Street 1:1029 KAPAHULU AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-1305
Practice Address - Country:US
Practice Address - Phone:808-218-7889
Practice Address - Fax:808-218-7981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD13649207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty