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General NPI Number Information
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NPI Number | 1528301850
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Entity Type | Organization
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Legal Business Name | CLYDE H. ISHII, MD, FACS, LLC
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Dates
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Enumeration Date | 04/04/2013
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Last Update Date | 04/04/2013
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Provider Practice Location Address
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Address Line | 1329 LUSITANA ST STE 304
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City | HONOLULU
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State | HI
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Zip | 96813-2411
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Country | US
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Telephone | 808-537-6630
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Fax | 808-536-4084
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Provider Business Mailing Address
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Address Line | 1329 LUSITANA ST STE 304
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City | HONOLULU
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State | HI
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Zip | 96813-2411
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Country | US
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Telephone | 808-537-6630
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Fax | 808-536-4084
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Authorized Official
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Title or Position | MEDICAL BILLER
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Name | MRS. PAULA C OKANO
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Credential | CPC
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Telephone | 808-537-6630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD5352
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License Number State | HI
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