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Contact Information

PHOUTHASONE PADAVONG
1 JARRETT WHITE RD
MOANALUA, HI96859-5001
 Phone: 808-433-4777
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Assistant, Podiatric

211D00000X
Indicates primary specialty

NPI Profile & details for PHOUTHASONE PADAVONG · (Male)

NPI Number 1760821649
Status Active
Credentials
Entity Individual
Enumeration date 06/24/2013
Last updated 06/24/2013 - About 13 years ago
Sole proprietor 1 Yes
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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