Provider Demographics
NPI:1821597170
Name:BURTON, REBECCA DEE (MD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:DEE
Last Name:BURTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 MOTT-SMITH DR APT 2404
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-2840
Mailing Address - Country:US
Mailing Address - Phone:808-931-9450
Mailing Address - Fax:
Practice Address - Street 1:900 FORT STREET MALL STE 1305
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3720
Practice Address - Country:US
Practice Address - Phone:808-441-1429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-01
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-13714174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator