Provider Demographics
NPI:1134150089
Name:KOBAYASHI, KEIICHI (MD)
Entity type:Individual
Prefix:DR
First Name:KEIICHI
Middle Name:
Last Name:KOBAYASHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 KAPIOLANI BLVD. #2000
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814
Mailing Address - Country:US
Mailing Address - Phone:808-945-3719
Mailing Address - Fax:808-945-3629
Practice Address - Street 1:1441 KAPIOLANI BLVD. #2000
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814
Practice Address - Country:US
Practice Address - Phone:808-945-3719
Practice Address - Fax:808-945-3629
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI7904207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI20983-3OtherBCBS
HI54545Medicare ID - Type Unspecified