Provider Demographics
NPI:1922240225
Name:KIMURA, MALIA (DPT)
Entity Type:Individual
Prefix:
First Name:MALIA
Middle Name:
Last Name:KIMURA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 LIPOA PKWY STE 135
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-6949
Mailing Address - Country:US
Mailing Address - Phone:808-879-5211
Mailing Address - Fax:808-879-5213
Practice Address - Street 1:535 LIPOA PKWY STE 135
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-6949
Practice Address - Country:US
Practice Address - Phone:808-879-5211
Practice Address - Fax:808-879-5213
Is Sole Proprietor?:No
Enumeration Date:2009-04-01
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-2227225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist