Provider Demographics
NPI:1528543881
Name:PINEIRO, GONZALO
Entity Type:Individual
Prefix:DR
First Name:GONZALO
Middle Name:
Last Name:PINEIRO
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 1:95-390 KUAHELANI AVE STE 3E
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-1190
Mailing Address - Country:US
Mailing Address - Phone:808-376-2913
Mailing Address - Fax:808-637-2643
Practice Address - Street 1:95-390 KUAHELANI AVE STE 3E
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-1190
Practice Address - Country:US
Practice Address - Phone:808-376-2913
Practice Address - Fax:808-637-2643
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-02
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1455111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty