Healthcare Provider Details

I. General information

NPI: 1679671838
Provider Name (Legal Business Name): JOEL E.H. KOBAYASHI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 02/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98-1247 KAAHUMANU ST STE 212
AIEA HI
96701-5310
US

IV. Provider business mailing address

98-1247 KAAHUMANU ST STE 212
AIEA HI
96701-5310
US

V. Phone/Fax

Practice location:
  • Phone: 808-487-5115
  • Fax: 808-488-8266
Mailing address:
  • Phone: 808-487-5115
  • Fax: 808-488-8266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number9742
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: