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NPI Code Detail

MEDICARE: RONALD MIMAKI PT

MEDICARE: RONALD MIMAKI PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT00007346WA
2225100000XPhysical Therapist5209HI

General Provider Information

NPI Number : 1134135072
Entity Type Code : Individual
Provider Name (Legal Business Name) : RONALD MIMAKI PT
Provider Business Mailing Address
First Line : 736 KALOLINA PL
Second Line :
City : KAILUA
State : HI
Zip : 96734-2047
Country : US
Telephone Number : 360-509-0628
Fax Number :
Provider Business Practice Location Address
First Line : 5722 KALANIANAOLE HWY LOWR LEVEL
Second Line :
City : HONOLULU
State : HI
Zip : 96821-2388
Country : US
Telephone Number : 808-373-3555
Fax Number : 808-373-3666
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2006
Last Update Date : 08/24/2021

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Directions to “ RONALD MIMAKI PT” Practice Location

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