Provider Demographics
NPI:1265462220
Name:GLIPA, JASON C (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:C
Last Name:GLIPA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1188 BISHOP ST
Mailing Address - Street 2:SUITE 3007
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3312
Mailing Address - Country:US
Mailing Address - Phone:808-599-1636
Mailing Address - Fax:808-599-8612
Practice Address - Street 1:1600 KAPIOLANI BLVD
Practice Address - Street 2:SUITE 620
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3807
Practice Address - Country:US
Practice Address - Phone:808-779-1799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIMD86622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI07829705Medicaid