Provider Demographics
NPI:1942315544
Name:PASCUAL, GRACE D (DPM)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:D
Last Name:PASCUAL
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1329 LUSITANA ST STE 801
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2434
Mailing Address - Country:US
Mailing Address - Phone:808-536-4335
Mailing Address - Fax:808-537-9195
Practice Address - Street 1:1329 LUSITANA ST STE 801
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2434
Practice Address - Country:US
Practice Address - Phone:808-536-4335
Practice Address - Fax:808-537-9195
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPO-133213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI08725102Medicaid
HI08725102Medicaid
HIU62479Medicare UPIN