Provider Demographics
NPI:1972616670
Name:KIMURA, CLAUDINE K Y (MD)
Entity Type:Individual
Prefix:
First Name:CLAUDINE
Middle Name:K Y
Last Name:KIMURA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5090 LIKINI ST APT 406
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-2376
Mailing Address - Country:US
Mailing Address - Phone:808-833-9152
Mailing Address - Fax:
Practice Address - Street 1:405 N KUAKINI ST STE 1103
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-6301
Practice Address - Country:US
Practice Address - Phone:808-596-7791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD11308207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI49928708Medicaid
HI54611Medicare ID - Type Unspecified
HI49928708Medicaid