Provider Demographics
NPI:1528394293
Name:KAJIWARA, KOJI (LAC, LMT)
Entity Type:Individual
Prefix:MR
First Name:KOJI
Middle Name:
Last Name:KAJIWARA
Suffix:
Gender:M
Credentials:LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-979 KAUOLU PL
Mailing Address - Street 2:#1202
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-6399
Mailing Address - Country:US
Mailing Address - Phone:808-721-4178
Mailing Address - Fax:808-593-2620
Practice Address - Street 1:1314 S KING ST
Practice Address - Street 2:#711
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1956
Practice Address - Country:US
Practice Address - Phone:808-721-4178
Practice Address - Fax:808-593-2620
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-30
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIACU-741171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist