Provider Demographics
NPI:1851956320
Name:ROBB T. SHIBAYAMA, O.D., INC
Entity Type:Organization
Organization Name:ROBB T. SHIBAYAMA, O.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ROBB
Authorized Official - Middle Name:T
Authorized Official - Last Name:SHIBAYAMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-225-7622
Mailing Address - Street 1:405 N KUAKINI ST STE 605
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-6302
Mailing Address - Country:US
Mailing Address - Phone:808-456-3937
Mailing Address - Fax:
Practice Address - Street 1:405 N KUAKINI ST STE 605
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-6302
Practice Address - Country:US
Practice Address - Phone:808-456-3937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROBB T. SHIBAYAMA, O.D., INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-09
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty