Healthcare Provider Details

I. General information

NPI: 1952302390
Provider Name (Legal Business Name): KIBERT T KATO O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 05/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

563 FARRINGTON HWY SUITE 205
KAPOLEI HI
96707-2031
US

IV. Provider business mailing address

563 FARRINGTON HWY SUITE 205
KAPOLEI HI
96707-2031
US

V. Phone/Fax

Practice location:
  • Phone: 808-693-8789
  • Fax: 808-693-8790
Mailing address:
  • Phone: 808-693-8789
  • Fax: 808-693-8790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOD-530
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: