Basic Information
| Provider Information | |||||||||
| NPI: | 1730369497 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LORRAINE SONODA-FOGEL MD INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1393 WAILUKU DR | ||||||||
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| City: | HILO | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967201217 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1190 WAIANUENUE AVE | ||||||||
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| City: | HILO | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967202020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8089744700 | ||||||||
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| ProviderEnumerationDate: | 11/10/2007 | ||||||||
| LastUpdateDate: | 11/10/2007 | ||||||||
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| AuthorizedOfficialLastName: | SONODA-FOGEL | ||||||||
| AuthorizedOfficialFirstName: | LORRAINE | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8082863484 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 7388 | HI | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.