Healthcare Provider Details

I. General information

NPI: 1124234331
Provider Name (Legal Business Name): ARLENE BALDILLO D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 10/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 N KUAKINI ST SUITE 201
HONOLULU HI
96817-2364
US

IV. Provider business mailing address

321 N KUAKINI ST SUITE 201
HONOLULU HI
96817-2364
US

V. Phone/Fax

Practice location:
  • Phone: 808-523-8611
  • Fax: 808-537-1594
Mailing address:
  • Phone: 808-523-8611
  • Fax: 808-537-1594

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number5101016241
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberDOS-1217
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: