Provider Demographics
NPI:1568615946
Name:ISHIBASHI, HERBERT PUALI'IALOHA (JD)
Entity Type:Individual
Prefix:
First Name:HERBERT
Middle Name:PUALI'IALOHA
Last Name:ISHIBASHI
Suffix:
Gender:M
Credentials:JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 KAPIOLANI ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-3937
Mailing Address - Country:US
Mailing Address - Phone:808-961-6635
Mailing Address - Fax:808-961-6925
Practice Address - Street 1:440 KAPIOLANI ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-3937
Practice Address - Country:US
Practice Address - Phone:808-961-6635
Practice Address - Fax:808-961-6925
Is Sole Proprietor?:No
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical