Provider Demographics
NPI:1780049478
Name:PANG, LORRIN (MD)
Entity type:Individual
Prefix:DR
First Name:LORRIN
Middle Name:
Last Name:PANG
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 1:166 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-5701
Mailing Address - Country:US
Mailing Address - Phone:808-870-1637
Mailing Address - Fax:
Practice Address - Street 1:166 RIVER RD
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-5701
Practice Address - Country:US
Practice Address - Phone:808-870-1637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-22
Last Update Date:2015-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-113562083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIMD-11356OtherMEDICAL LICENSE
HIMD-11356OtherSTATE LICENSE