Provider Demographics
NPI:1184811986
Name:PAPIN, GERALD (PA-C)
Entity type:Individual
Prefix:
First Name:GERALD
Middle Name:
Last Name:PAPIN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 KAMOKILA BLVD
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-5607
Mailing Address - Country:US
Mailing Address - Phone:808-432-3600
Mailing Address - Fax:
Practice Address - Street 1:401 KAMOKILA BLVD
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-5607
Practice Address - Country:US
Practice Address - Phone:808-432-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-26
Last Update Date:2023-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAMD-747363A00000X
AZ2437363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant