Provider Demographics
NPI:1386644862
Name:SORIANO, GILDO SABANPAN (MD)
Entity Type:Individual
Prefix:DR
First Name:GILDO
Middle Name:SABANPAN
Last Name:SORIANO
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 1:916 KILANI AVE
Mailing Address - Street 2:
Mailing Address - City:WAHIAWA
Mailing Address - State:HI
Mailing Address - Zip Code:96786-2102
Mailing Address - Country:US
Mailing Address - Phone:808-621-5042
Mailing Address - Fax:808-621-9313
Practice Address - Street 1:916 KILANI AVE
Practice Address - Street 2:
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786-2102
Practice Address - Country:US
Practice Address - Phone:808-621-5042
Practice Address - Fax:808-621-9313
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2466207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0038166OtherHMBA
HI03455001Medicaid
HI0038166OtherHMBA
HI03455001Medicaid