Provider Demographics
NPI:1508836271
Name:MADJAR GALANTO, JUTTA (MD)
Entity Type:Individual
Prefix:MRS
First Name:JUTTA
Middle Name:
Last Name:MADJAR GALANTO
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 1:820 MILILANI ST
Mailing Address - Street 2:STE 702A, BILLING SOLUTIONS LLP
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813
Mailing Address - Country:US
Mailing Address - Phone:808-523-9363
Mailing Address - Fax:808-523-9418
Practice Address - Street 1:2424 KALAKAUA AVE
Practice Address - Street 2:4TH FLOOR, DIAMOND HEAD TOWER
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815
Practice Address - Country:US
Practice Address - Phone:808-922-6000
Practice Address - Fax:808-922-2680
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD9977207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIF00154538OtherMEDICARE RAILROAD
HIDC2078OtherMEDICARE RAILROAD
HI56368Medicare ID - Type Unspecified
HIDC2078OtherMEDICARE RAILROAD