Provider Demographics
NPI:1720270408
Name:MALCOLM R. ING, M.D., INC.
Entity Type:Organization
Organization Name:MALCOLM R. ING, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MALCOLM
Authorized Official - Middle Name:R
Authorized Official - Last Name:ING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-955-5951
Mailing Address - Street 1:1319 PUNAHOU ST
Mailing Address - Street 2:SUITE 1110
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-1001
Mailing Address - Country:US
Mailing Address - Phone:808-955-5951
Mailing Address - Fax:808-941-8646
Practice Address - Street 1:1319 PUNAHOU ST
Practice Address - Street 2:SUITE 1110
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1001
Practice Address - Country:US
Practice Address - Phone:808-955-5951
Practice Address - Fax:808-941-8646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD1599207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI028896-01Medicaid
HI3226-8OtherHMSA
HI3226-8OtherHMSA
H102956Medicare PIN