1598797409 NPI number — MISS RENAE HOONG LAN SHIGEMURA ATC

Table of content: MISS RENAE HOONG LAN SHIGEMURA ATC (NPI 1598797409)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598797409 NPI number — MISS RENAE HOONG LAN SHIGEMURA ATC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHIGEMURA
Provider First Name:
RENAE
Provider Middle Name:
HOONG LAN
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
ATC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598797409
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
98-1921 WILOU ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AIEA
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96701-1663
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-487-5306
Provider Business Mailing Address Fax Number:
808-956-5717

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1337 LOWER CAMPUS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96822-2312
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-956-7144
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/07/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2255A2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)