Healthcare Provider Details

I. General information

NPI: 1265902555
Provider Name (Legal Business Name): LIANA TSURUKO KOBAYASHI DO, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2018
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date: 05/30/2020
Reactivation Date: 07/08/2020

III. Provider practice location address

94-1211 FARRINGTON HWY BLDG AA
WAIPAHU HI
96797-3205
US

IV. Provider business mailing address

94-1211 FARRINGTON HWY BLDG AA
WAIPAHU HI
96797-3205
US

V. Phone/Fax

Practice location:
  • Phone: 808-835-6244
  • Fax: 808-678-9644
Mailing address:
  • Phone: 808-835-6244
  • Fax: 808-678-9644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License NumberDOS-2427-0
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDOSR-503
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34.016481
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDOS-2427-0
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: