Provider Demographics
NPI:1942585096
Name:CABATBAT, REBECCA (OD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:CABATBAT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 CENTER STREET SUITE #2
Mailing Address - Street 2:
Mailing Address - City:WAHIAWA
Mailing Address - State:HI
Mailing Address - Zip Code:96786-2953
Mailing Address - Country:US
Mailing Address - Phone:808-622-4121
Mailing Address - Fax:
Practice Address - Street 1:960 CENTER ST STE 2
Practice Address - Street 2:
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786-2038
Practice Address - Country:US
Practice Address - Phone:808-622-4121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-19
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI796152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist