MEDICARE: DR. CHRYSTIE KIMIE FUJIMOTO M.D.

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
1	207V00000X	Obstetrics & Gynecology Physician	15081	HI

General Provider Information

NPI Number	:	1144426909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRYSTIE KIMIE FUJIMOTO M.D.

Provider Business Mailing Address
First Line	:	1401 S BERETANIA ST STE 310
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96814-1872
Country	:	US
Telephone Number	:	808-524-4055
Fax Number	:	808-524-4057

Provider Business Practice Location Address
First Line	:	1401 S BERETANIA ST STE 310
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96814-1872
Country	:	US
Telephone Number	:	808-524-4055
Fax Number	:	808-524-4057

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2007
Last Update Date	:	10/14/2014

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