Provider Demographics
NPI:1124038625
Name:KOBAYASHI, GREGORY KIYOSHI (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:KIYOSHI
Last Name:KOBAYASHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 N KUAKINI ST
Mailing Address - Street 2:KUAKINI MEDICAL CENTER
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2336
Mailing Address - Country:US
Mailing Address - Phone:808-547-9496
Mailing Address - Fax:808-547-9497
Practice Address - Street 1:347 N KUAKINI ST
Practice Address - Street 2:KUAKINI MEDICAL CENTER
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2336
Practice Address - Country:US
Practice Address - Phone:808-547-9496
Practice Address - Fax:808-547-9497
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI10963207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0225250OtherHMSA
HI496267 01Medicaid
HI53089Medicare ID - Type Unspecified
H20528Medicare UPIN