Provider Demographics
NPI:1760720957
Name:WILLIAM G. OBANA, M.D., INC.
Entity Type:Organization
Organization Name:WILLIAM G. OBANA, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:OBANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-523-9993
Mailing Address - Street 1:1380 LUSITANA ST STE 410
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2440
Mailing Address - Country:US
Mailing Address - Phone:808-523-9993
Mailing Address - Fax:808-523-9992
Practice Address - Street 1:1380 LUSITANA ST STE 410
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2440
Practice Address - Country:US
Practice Address - Phone:808-523-9993
Practice Address - Fax:808-523-9992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-8018207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI03501201Medicaid
HI38703OtherHMSA