Provider Demographics
NPI:1265632194
Name:GARCIA, MIKI SHIRAKAWA (MD)
Entity Type:Individual
Prefix:
First Name:MIKI
Middle Name:SHIRAKAWA
Last Name:GARCIA
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 1:1329 LUSITANA ST
Mailing Address - Street 2:SUITE 109
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2429
Mailing Address - Country:US
Mailing Address - Phone:808-536-9888
Mailing Address - Fax:808-585-8450
Practice Address - Street 1:1329 LUSITANA ST
Practice Address - Street 2:SUITE 109
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2429
Practice Address - Country:US
Practice Address - Phone:808-536-9888
Practice Address - Fax:808-585-8450
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA96590207N00000X
HIMD-16031207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology