Healthcare Provider Details

I. General information

NPI: 1841223450
Provider Name (Legal Business Name): MARINA AQUIRAN BADUA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 08/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1712 LILIHA ST SUITE 202
HONOLULU HI
96817-5410
US

IV. Provider business mailing address

2164 PUNA ST
HONOLULU HI
96817-1520
US

V. Phone/Fax

Practice location:
  • Phone: 808-536-1754
  • Fax: 808-536-0315
Mailing address:
  • Phone: 808-478-3400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD3187
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: