MEDICARE: JASON C GLIPA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	MD8662	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265462220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON C GLIPA M.D.

Provider Business Mailing Address
First Line	:	1188 BISHOP ST
Second Line	:	SUITE 3007
City	:	HONOLULU
State	:	HI
Zip	:	96813-3312
Country	:	US
Telephone Number	:	808-599-1636
Fax Number	:	808-599-8612

Provider Business Practice Location Address
First Line	:	1600 KAPIOLANI BLVD
Second Line	:	SUITE 620
City	:	HONOLULU
State	:	HI
Zip	:	96814-3807
Country	:	US
Telephone Number	:	808-779-1799
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	07/08/2007

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