Provider Demographics
NPI:1205394095
Name:HAWAII PATHOLOGISTS' LABORATORY
Entity type:Organization
Organization Name:HAWAII PATHOLOGISTS' LABORATORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-389-3195
Mailing Address - Street 1:702 S BERETANIA ST STE B100
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2581
Mailing Address - Country:US
Mailing Address - Phone:808-538-2702
Mailing Address - Fax:
Practice Address - Street 1:1301 PUNCHBOWL ST FL 4
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2402
Practice Address - Country:US
Practice Address - Phone:808-691-4271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-11
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical LaboratoryGroup - Multi-Specialty