Provider Demographics
NPI:1235226580
Name:MONTANIA, BILL NOBORU (MD)
Entity Type:Individual
Prefix:DR
First Name:BILL
Middle Name:NOBORU
Last Name:MONTANIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4224 WALALAE AVE #5 356
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816
Mailing Address - Country:US
Mailing Address - Phone:808-946-5385
Mailing Address - Fax:808-946-5387
Practice Address - Street 1:1301 PUNCHBOWL ST
Practice Address - Street 2:QUUEENS MEDICAL CENTER
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816
Practice Address - Country:US
Practice Address - Phone:808-946-5385
Practice Address - Fax:808-946-5387
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD4224207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00279301Medicaid
D0001976OtherHIHMSA BCBS
HIMD4224OtherMD LICENSE
HIMD4224OtherMD LICENSE
HIH0000BDTRGMedicare ID - Type Unspecified