Provider Demographics
NPI:1710662135
Name:ABIDA, MATILDE BAYUDAN (LMT)
Entity Type:Individual
Prefix:
First Name:MATILDE
Middle Name:BAYUDAN
Last Name:ABIDA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1559 MEYERS ST APT B
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-2590
Mailing Address - Country:US
Mailing Address - Phone:808-291-1464
Mailing Address - Fax:
Practice Address - Street 1:94-810 MOLOALO ST STE 220
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3355
Practice Address - Country:US
Practice Address - Phone:808-671-1711
Practice Address - Fax:808-671-1705
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT-8529225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist