1952394660 NPI number — DR. JOANNE SORIANO RIGDON O.D.

Table of content: KELSEY LAUREN MORRIS (NPI 1922428614)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952394660 NPI number — DR. JOANNE SORIANO RIGDON O.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIGDON
Provider First Name:
JOANNE
Provider Middle Name:
SORIANO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
O.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SORIANO
Provider Other First Name:
JOANNE
Provider Other Middle Name:
LEE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
O.D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1952394660
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/21/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1029 KAPAHULU AVE STE 502
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96816-1332
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-782-1861
Provider Business Mailing Address Fax Number:
808-218-7830

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1029 KAPAHULU AVE STE 502
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96816-1332
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-782-1861
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/26/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  OD-575 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00B0237129 . This is a "HMSA" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 00A0237121 . This is a "HMSA" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 529018-01 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".