Provider Demographics
NPI:1083903405
Name:LUIS J. RAGUNTON, M.D., INC.
Entity Type:Organization
Organization Name:LUIS J. RAGUNTON, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D. /PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:RAGUNTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-488-8750
Mailing Address - Street 1:98-1079 MOANALUA RD
Mailing Address - Street 2:SUITE 440
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4713
Mailing Address - Country:US
Mailing Address - Phone:808-488-8750
Mailing Address - Fax:808-487-5910
Practice Address - Street 1:98-1079 MOANALUA RD
Practice Address - Street 2:SUITE 440
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4713
Practice Address - Country:US
Practice Address - Phone:808-488-8750
Practice Address - Fax:808-487-5910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIC98598Medicare UPIN