Provider Demographics
NPI:1255144291
Name:TYLER KIMURA AGENCY LLC
Entity type:Organization
Organization Name:TYLER KIMURA AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:TAKAMI
Authorized Official - Last Name:KIMURA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-207-8558
Mailing Address - Street 1:99-619 HOOHALAWAI PL
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-3647
Mailing Address - Country:US
Mailing Address - Phone:808-221-8425
Mailing Address - Fax:
Practice Address - Street 1:1001 DILLINGHAM BLVD STE 317
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-4551
Practice Address - Country:US
Practice Address - Phone:808-207-8558
Practice Address - Fax:808-207-8557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care