Provider Demographics
NPI:1922744002
Name:VO, KRISTINE BASTO
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:BASTO
Last Name:VO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1356 LUSITANA ST FL 7
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2409
Mailing Address - Country:US
Mailing Address - Phone:808-586-2910
Mailing Address - Fax:
Practice Address - Street 1:1356 LUSITANA ST FL 7
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2409
Practice Address - Country:US
Practice Address - Phone:808-586-2910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-11
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMDR-8300-0207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine