Provider Demographics
NPI:1598005472
Name:CYRIL K GOSHIMA MD INC
Entity Type:Organization
Organization Name:CYRIL K GOSHIMA MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CYRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:GOSHIMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-737-7947
Mailing Address - Street 1:3221 WAIALAE AVE
Mailing Address - Street 2:SUITE 382
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5842
Mailing Address - Country:US
Mailing Address - Phone:808-737-7947
Mailing Address - Fax:808-732-9463
Practice Address - Street 1:3221 WAIALAE AVE
Practice Address - Street 2:SUITE 382
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-5842
Practice Address - Country:US
Practice Address - Phone:808-737-7947
Practice Address - Fax:808-732-9463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-28
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI01013002Medicaid
HI01013002Medicaid
HIH0000BDJSGMedicare PIN