Provider Demographics
NPI:1376162511
Name:HIRABAYASHI, KYLE
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:HIRABAYASHI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3214 VAN NOSTRAN DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-1455
Mailing Address - Country:US
Mailing Address - Phone:562-607-9277
Mailing Address - Fax:
Practice Address - Street 1:310 E. 14TH STREET
Practice Address - Street 2:SOUTH BUILDING, 6TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-979-4181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program