Healthcare Provider Details

I. General information

NPI: 1003913146
Provider Name (Legal Business Name): SORBELLA MAULIT GUILLERMO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 08/22/2020
Certification Date: 08/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94-300 FARRINGTON HWY #F-8
WAIPAHU HI
96797-2648
US

IV. Provider business mailing address

916 KILANI AVE
WAHIAWA HI
96786-2102
US

V. Phone/Fax

Practice location:
  • Phone: 808-677-1433
  • Fax: 808-677-1676
Mailing address:
  • Phone: 808-677-1433
  • Fax: 808-677-1676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number8981
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number8981
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: