Provider Demographics
NPI:1497738686
Name:OBANA, WILLIAM GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:GEORGE
Last Name:OBANA
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 1:1380 LUSITANA ST
Mailing Address - Street 2:SUITE #410
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2449
Mailing Address - Country:US
Mailing Address - Phone:808-523-9993
Mailing Address - Fax:808-523-9992
Practice Address - Street 1:1380 LUSITANA ST
Practice Address - Street 2:SUITE #410
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2449
Practice Address - Country:US
Practice Address - Phone:808-523-9993
Practice Address - Fax:808-523-9992
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI8018174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI03501201Medicaid
HI38703OtherHMSA
HI03501201Medicaid