Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | M001025 | GU |
Y | 208600000X | Surgeon | M001025 | GU |
N | 2086S0129X | Vascular Surgeon | M001025 | GU |
NPI | 1104975689 |
---|---|
Provider Name | Ronald T Kobayashi |
First Address | Tamuning, GU 96913 |
Second Address | Tamuning, GU 96913 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2007 |
Last Update Date | 18/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0000BFDBR | (02) |