Provider Demographics
NPI:1780645689
Name:KUBO, BRIAN TOSHIO (OD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:TOSHIO
Last Name:KUBO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95-1028 AKALULI ST
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-4433
Mailing Address - Country:US
Mailing Address - Phone:808-395-6578
Mailing Address - Fax:
Practice Address - Street 1:333 KEAHOLE ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-3428
Practice Address - Country:US
Practice Address - Phone:808-395-6578
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOD 281152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIU48785Medicare UPIN