Provider Demographics
NPI:1720421118
Name:PHAN, CASEY MARIE (MD)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:MARIE
Last Name:PHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:737 BISHOP ST STE 2060
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3214
Mailing Address - Country:US
Mailing Address - Phone:808-353-8390
Mailing Address - Fax:808-533-4008
Practice Address - Street 1:1301 PUNCHBOWL STREET
Practice Address - Street 2:IOLANI 4 PATHOLOGY
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813
Practice Address - Country:US
Practice Address - Phone:808-691-4271
Practice Address - Fax:808-691-4045
Is Sole Proprietor?:No
Enumeration Date:2013-04-16
Last Update Date:2024-05-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD459804207ZP0102X
MDD85427207ZP0102X
HIMD-20036207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology