Provider Demographics
NPI:1649909631
Name:MCBRIDE, HIROMI
Entity type:Individual
Prefix:
First Name:HIROMI
Middle Name:
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6082 KALANIANAOLE HWY
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96821-2374
Mailing Address - Country:US
Mailing Address - Phone:808-491-8027
Mailing Address - Fax:
Practice Address - Street 1:1357 KAPIOLANI BLVD STE 800
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4536
Practice Address - Country:US
Practice Address - Phone:808-523-9043
Practice Address - Fax:808-526-0268
Is Sole Proprietor?:No
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT7167225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist