Healthcare Provider Details

I. General information

NPI: 1477555449
Provider Name (Legal Business Name): LLOYD T KOBAYASHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 03/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98-1079 MOANALUA RD SUITE 450
AIEA HI
96701-4713
US

IV. Provider business mailing address

98-1079 MOANALUA RD SUITE 450
AIEA HI
96701-4713
US

V. Phone/Fax

Practice location:
  • Phone: 808-488-7747
  • Fax: 808-484-0760
Mailing address:
  • Phone: 808-488-7747
  • Fax: 808-484-0760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number3802
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: