Provider Demographics
NPI:1952302390
Name:KATO, KIBERT T (OD)
Entity Type:Individual
Prefix:DR
First Name:KIBERT
Middle Name:T
Last Name:KATO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:563 FARRINGTON HWY
Mailing Address - Street 2:SUITE 205
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-2031
Mailing Address - Country:US
Mailing Address - Phone:808-693-8789
Mailing Address - Fax:808-693-8790
Practice Address - Street 1:563 FARRINGTON HWY
Practice Address - Street 2:SUITE 205
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-2031
Practice Address - Country:US
Practice Address - Phone:808-693-8789
Practice Address - Fax:808-693-8790
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOD-530152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIB229589OtherHMSA
HIB229589OtherHMSA
HIH53611Medicare PIN