Provider Demographics
NPI:1295887685
Name:RIZZO, MARCO (MD)
Entity type:Individual
Prefix:DR
First Name:MARCO
Middle Name:
Last Name:RIZZO
Suffix:
Gender:M
Credentials:MD
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
Mailing Address - Street 2:SUITE 401
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2429
Mailing Address - Country:US
Mailing Address - Phone:808-533-2900
Mailing Address - Fax:808-531-8991
Practice Address - Street 1:1329 LUSITANA ST
Practice Address - Street 2:SUITE 401
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2429
Practice Address - Country:US
Practice Address - Phone:808-533-2900
Practice Address - Fax:808-531-8991
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-23922086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIMD-2393OtherSTATE MD LICENSE #
HI3850-5OtherHMSA PROVIDER ID NUMBER
HI0000BDSDLMedicare ID - Type Unspecified
HI3850-5OtherHMSA PROVIDER ID NUMBER