Provider Demographics
NPI:1033238779
Name:GALLER-RIMM, GABRIELLE (MD)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:GALLER-RIMM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 759
Mailing Address - Street 2:
Mailing Address - City:MAKAWAO
Mailing Address - State:HI
Mailing Address - Zip Code:96768-0759
Mailing Address - Country:US
Mailing Address - Phone:808-298-1165
Mailing Address - Fax:808-572-4500
Practice Address - Street 1:1043 MAKAWAO AVE,
Practice Address - Street 2:SUITE 106
Practice Address - City:MAKAWAO
Practice Address - State:HI
Practice Address - Zip Code:96768
Practice Address - Country:US
Practice Address - Phone:808-298-1165
Practice Address - Fax:808-572-4500
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-123122080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00A0252286OtherHMSA PROVIDER NUMBER