Provider Demographics
NPI:1669426862
Name:AVILLA, EMMA B (MD)
Entity type:Individual
Prefix:DR
First Name:EMMA
Middle Name:B
Last Name:AVILLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:EMMA
Other - Middle Name:B
Other - Last Name:AVILLA-DELANEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1728 DILLINGHAM BLVD
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-4017
Mailing Address - Country:US
Mailing Address - Phone:808-842-1585
Mailing Address - Fax:808-847-5961
Practice Address - Street 1:1728 DILLINGHAM BLVD
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819
Practice Address - Country:US
Practice Address - Phone:808-842-1585
Practice Address - Fax:808-847-5961
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-10202207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIB221958OtherHMSA
HI08842801Medicaid
HIB221958OtherHMSA
HIH54099Medicare ID - Type Unspecified