Basic Information
| Provider Information | |||||||||
| NPI: | 1124255625 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KEMBLE LUO | ||||||||
| FirstName: | ANNE | ||||||||
| MiddleName: | SHIMODA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 550 S BERETANIA ST | ||||||||
| Address2: | #601, QUEENS HEART PHYSICIAN PRACTICE | ||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968132414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8086918900 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 550 S BERETANIA ST | ||||||||
| Address2: | #601, QUEENS HEART PHYSICIAN PRACTICE | ||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968132414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8086918900 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2009 | ||||||||
| LastUpdateDate: | 03/17/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | A134830 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0000X | A134830 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RC0000X | 16607 | HI | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.