Healthcare Provider Details

I. General information

NPI: 1265493662
Provider Name (Legal Business Name): MINA GANAPATHY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MINA BHATIA

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 S KING ST SUITE 908
HONOLULU HI
96814-1922
US

IV. Provider business mailing address

820 MILILANI ST SUITE 702A
HONOLULU HI
96813-2924
US

V. Phone/Fax

Practice location:
  • Phone: 808-597-1999
  • Fax: 808-597-1201
Mailing address:
  • Phone: 808-523-9363
  • Fax: 808-523-9418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD8499
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: