Provider Demographics
NPI:1467515726
Name:KANESHIRO, STANLEY
Entity Type:Individual
Prefix:MR
First Name:STANLEY
Middle Name:
Last Name:KANESHIRO
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:PSC 559 BOX 6425
Mailing Address - Street 2:
Mailing Address - City:OKINAWA
Mailing Address - State:FPO
Mailing Address - Zip Code:AP
Mailing Address - Country:JP
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PSC 559 BOX 6425
Practice Address - Street 2:
Practice Address - City:OKINAWA
Practice Address - State:FPO
Practice Address - Zip Code:AP
Practice Address - Country:JP
Practice Address - Phone:0803-152-8663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman