Provider Demographics
NPI:1265493662
Name:GANAPATHY, MINA (MD)
Entity Type:Individual
Prefix:
First Name:MINA
Middle Name:
Last Name:GANAPATHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MINA
Other - Middle Name:
Other - Last Name:BHATIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:820 MILILANI ST
Mailing Address - Street 2:SUITE 702A
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2924
Mailing Address - Country:US
Mailing Address - Phone:808-523-9363
Mailing Address - Fax:808-523-9418
Practice Address - Street 1:1150 S KING ST
Practice Address - Street 2:SUITE 908
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1922
Practice Address - Country:US
Practice Address - Phone:808-597-1999
Practice Address - Fax:808-597-1201
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD8499207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000008106Medicaid
HI00D008138OtherHMSA
HIF77804Medicare UPIN
HI0000008106Medicaid