Healthcare Provider Details

I. General information

NPI: 1497738686
Provider Name (Legal Business Name): WILLIAM GEORGE OBANA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 01/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 LUSITANA ST SUITE #410
HONOLULU HI
96813-2449
US

IV. Provider business mailing address

1380 LUSITANA ST SUITE #410
HONOLULU HI
96813-2449
US

V. Phone/Fax

Practice location:
  • Phone: 808-523-9993
  • Fax: 808-523-9992
Mailing address:
  • Phone: 808-523-9993
  • Fax: 808-523-9992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number8018
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: