Healthcare Provider Details

I. General information

NPI: 1891740809
Provider Name (Legal Business Name): EMILIO A GANITANO JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2230 LILIHA ST CRITICAL CARE DEPT.
HONOLULU HI
96817-1646
US

IV. Provider business mailing address

1585 KAPIOLANI BLVD SUITE 1800
HONOLULU HI
96814-4522
US

V. Phone/Fax

Practice location:
  • Phone: 808-781-2241
  • Fax: 808-949-0483
Mailing address:
  • Phone: 808-941-3363
  • Fax: 808-949-0483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD12864
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMD12864
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: