Provider Demographics
NPI:1306641410
Name:KOMESU, ROYCE SEIJI (PT, DPT)
Entity type:Individual
Prefix:
First Name:ROYCE
Middle Name:SEIJI
Last Name:KOMESU
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1228 AKIAHALA ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4227
Mailing Address - Country:US
Mailing Address - Phone:808-284-7927
Mailing Address - Fax:
Practice Address - Street 1:3221 WAIALAE AVE STE 300
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-5845
Practice Address - Country:US
Practice Address - Phone:808-737-4244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-6110225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist