Provider Demographics
NPI:1366550865
Name:KOBASHIGAWA, IZUMI SIDNEY (MD)
Entity type:Individual
Prefix:DR
First Name:IZUMI
Middle Name:SIDNEY
Last Name:KOBASHIGAWA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:321 N KUAKINI STREET
Mailing Address - Street 2:SUITE 310
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2360
Mailing Address - Country:US
Mailing Address - Phone:808-528-2877
Mailing Address - Fax:808-528-2878
Practice Address - Street 1:321 N KUAKINI STREET
Practice Address - Street 2:SUITE 310
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2360
Practice Address - Country:US
Practice Address - Phone:808-528-2877
Practice Address - Fax:808-528-2878
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIMD5067207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI01627901Medicaid
HI01627901Medicaid
HIH0000BDKZTMedicare ID - Type Unspecified