Provider Demographics
NPI:1568411585
Name:KAGIHARA, LANCE MIKIO (MD)
Entity Type:Individual
Prefix:
First Name:LANCE
Middle Name:MIKIO
Last Name:KAGIHARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 N KUAKINI ST
Mailing Address - Street 2:STE 701
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817
Mailing Address - Country:US
Mailing Address - Phone:808-528-5020
Mailing Address - Fax:808-528-5022
Practice Address - Street 1:321 N KUAKINI ST
Practice Address - Street 2:STE 701
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817
Practice Address - Country:US
Practice Address - Phone:808-528-5020
Practice Address - Fax:808-528-5022
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2008-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI03834207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI04820102Medicaid
C98477Medicare UPIN
H0000BDLVNMedicare PIN