Organization Active NPI

Glenda V. Malana, M.D. LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Ewa Beach, HI
National Provider Identifier
1629257498
Registry record updated Oct 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
MD-9620 Issued in HI
Legal business name
GLENDA V. MALANA, M.D. LLC
Practice address
91-2139 Fort Weaver Rd Ste 302
Ewa Beach, HI 96706-3609
Phone
(808) 678-0045
Fax
(808) 678-0048
NPI assigned
Oct 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Glenda Malana, M.D.NPI 1639103070
Title
Owner
Phone
(808) 678-0045

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0300X MD-9620 HI Primary

Addresses

Primary practice location

91-2139 Fort Weaver Rd Ste 302
Ewa Beach, HI 96706-3609

Mailing address

91-2139 Fort Weaver Rd Ste 302
Ewa Beach, HI 96706-3609
Phone (808) 678-0045

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071126000126 HI Part B Supplier - Clinic/Group Practice 7517055791 Receives reassigned benefits from 1 practitioner
Practice locations: Ewa Beach, HI

National Provider Directory

National Provider Directory

Locations

91-2139 Fort Weaver Rd
Ste 302
Ewa Beach, HI 96706
Phone (775) 219-6855

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193702400000",
    "number": "1629257498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-2139 FORT WEAVER RD STE 302",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967063609",
            "telephone_number": "808-678-0045",
            "fax_number": "808-678-0048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-2139 FORT WEAVER RD STE 302",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967063609",
            "telephone_number": "808-678-0045",
            "fax_number": "808-678-0048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDA V. MALANA, M.D. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-30",
        "last_updated": "2007-10-30",
        "status": "A",
        "authorized_official_last_name": "MALANA",
        "authorized_official_first_name": "GLENDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-678-0045",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "HI",
            "license": "MD-9620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ewa Beach, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.