Provider Demographics
NPI:1497075550
Name:MANIPON, GILBERT (LMT)
Entity Type:Individual
Prefix:
First Name:GILBERT
Middle Name:
Last Name:MANIPON
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 ALA WAI BLVD
Mailing Address - Street 2:SUITE #703
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-2216
Mailing Address - Country:US
Mailing Address - Phone:808-386-4693
Mailing Address - Fax:808-926-5965
Practice Address - Street 1:2121 ALA WAI BLVD
Practice Address - Street 2:SUITE #703
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-2216
Practice Address - Country:US
Practice Address - Phone:808-386-4693
Practice Address - Fax:808-926-5965
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-10
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT #5930225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist