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Individual

DR. KATHY A.K. ISHIMOTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
94-849 LUMIAINA STREET, SUITE 103, WAIPAHU, HI 96797
(808) 671-1656
(808) 671-2020
Mailing address
94-849 LUMIAINA STREET, SUITE 103, WAIPAHU, HI 96797
(808) 671-1656
(808) 671-2020

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
161
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
55923
GROUP NUMBER HONOLULU SIT
HI
01
55928
GROUP NUMBER WAIPAHU SITE
HI
Enumeration date
01/05/2007
Last updated
09/11/2012
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