Provider Demographics
NPI:1952394660
Name:RIGDON, JOANNE SORIANO (OD)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:SORIANO
Last Name:RIGDON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:JOANNE
Other - Middle Name:LEE
Other - Last Name:SORIANO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:1029 KAPAHULU AVE STE 502
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-1332
Mailing Address - Country:US
Mailing Address - Phone:808-782-1861
Mailing Address - Fax:808-218-7830
Practice Address - Street 1:1029 KAPAHULU AVE STE 502
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-1332
Practice Address - Country:US
Practice Address - Phone:808-782-1861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOD-575152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00B0237129OtherHMSA
HI00A0237121OtherHMSA
HI529018-01Medicaid
U91177Medicare UPIN
HI529018-01Medicaid