Healthcare Provider Details

I. General information

NPI: 1376574327
Provider Name (Legal Business Name): CHERYLE GANAL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 01/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 S KING ST
HONOLULU HI
96813-3097
US

IV. Provider business mailing address

1329 LUSITANA ST SUITE 704
HONOLULU HI
96813-2429
US

V. Phone/Fax

Practice location:
  • Phone: 808-522-4000
  • Fax:
Mailing address:
  • Phone: 808-524-2100
  • Fax: 808-534-0593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number11826
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: