Provider Demographics
NPI:1245254895
Name:SOMAL, AMENDEEP K (MD)
Entity type:Individual
Prefix:DR
First Name:AMENDEEP
Middle Name:K
Last Name:SOMAL
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 1:226 N KUAKINI ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2421
Mailing Address - Country:US
Mailing Address - Phone:808-566-3460
Mailing Address - Fax:808-535-1572
Practice Address - Street 1:226 N KUAKINI ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2421
Practice Address - Country:US
Practice Address - Phone:808-566-3460
Practice Address - Fax:808-535-1572
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD13067208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI557605-03Medicaid
HI557605-03Medicaid
HIH96373Medicare UPIN