Provider Demographics
NPI:1093450454
Name:SERRANILLA-SONIDO, AGNES (MD)
Entity type:Individual
Prefix:DR
First Name:AGNES
Middle Name:
Last Name:SERRANILLA-SONIDO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-837 WAIPAHU ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-3320
Mailing Address - Country:US
Mailing Address - Phone:808-671-3911
Mailing Address - Fax:808-677-2720
Practice Address - Street 1:94-837 WAIPAHU ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3320
Practice Address - Country:US
Practice Address - Phone:808-671-3911
Practice Address - Fax:808-677-2720
Is Sole Proprietor?:No
Enumeration Date:2022-04-30
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMDR-8277207Q00000X
HIMD-25424207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI012475Medicaid