Paradise Medical Services LLC
General Practice in Wailuku, HI. Organization (NPI-2).
NPI number1124666201
StatusActive
Last updated in NPPESJan 27, 2022
Details
- NPI
- 1124666201
- Entity type
- Organization (NPI-2)
- Legal business name
- Paradise Medical Services LLC
- Organization subpart
- No
- Enumeration date
- Dec 19, 2019
- Certification date
- Jan 27, 2022
- Last updated
- Jan 27, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | – | – | Yes |
Other names
- Paradise Medical (Doing Business As)
Practice location
2120 Kaohu StWailuku, HI 96793-2205
Phone 808-377-4734 · Fax 808-377-4734
Mailing address
2120 Kaohu StWailuku, HI 96793-2205
Phone 808-377-4734 · Fax 808-377-4734
Authorized official
Jessica S B Mendonsa
Provider/LLC Member
8083774734
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All 6 General Practice Physician providers in Wailuku · All 1,418 providers in Wailuku
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