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General NPI Number Information
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NPI Number | 1265788806
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Entity Type | Organization
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Legal Business Name | ROBB T. SHIBAYAMA, O.D., INC
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Dates
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Enumeration Date | 08/01/2012
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Last Update Date | 10/17/2012
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Provider Practice Location Address
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Address Line | 750 KEEAUMOKU ST
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City | HONOLULU
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State | HI
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Zip | 96814-3014
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Country | US
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Telephone | 808-945-3937
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Fax | 808-945-9859
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Provider Business Mailing Address
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Address Line | 1228 ALA AUPAKA PL
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City | HONOLULU
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State | HI
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Zip | 96818-2232
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Country | US
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Telephone | 808-225-7622
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Fax | 808-945-9859
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBB T. SHIBAYAMA
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Credential | OD
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Telephone | 808-225-7622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OD529
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License Number State | HI
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