DEREK R ILLASTRON

KAHULUI, HI
NPI1790949956
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: HI  MD-18353)
Additional Taxonomies207R00000X Internal Medicine
(Licence: MA  235414)
Enumeration Date2008-07-16
Last Update Date2019-03-19
Business Address
DEREK R ILLASTRON MD
110 E KAAHUMANU AVE
KAHULUI, HI 96732-2118
Phone number: 808-242-6464
Mailing Address
DEREK R ILLASTRON MD
2180 MAIN ST
WAILUKU, HI 96793-1625
Phone number: 808-242-6464