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General NPI Number Information
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NPI Number | 1164681763
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Entity Type | Individual
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Provider Name | CYNTHIA YW SHIMODA A.T.C.
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Gender | Female
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Dates
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Enumeration Date | 06/09/2008
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Last Update Date | 06/09/2008
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Provider Practice Location Address
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Address Line | 2825 ALA ILIMA ST
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City | HONOLULU
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State | HI
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Zip | 96818-1702
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Country | US
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Telephone | 808-837-8065
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Fax | 808-831-7920
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Provider Business Mailing Address
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Address Line | 45-528 APAPANE ST
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City | KANEOHE
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State | HI
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Zip | 96744-1912
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Country | US
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Telephone | 808-537-4970
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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