Basic Information
Provider Information
NPI: 1972571008
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HIRABAYASHI
FirstName: CHRISTINE
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1505 KALAEPOHAKU PL
Address2:  
City: HONOLULU
State: HI
PostalCode: 968161828
CountryCode: US
TelephoneNumber: 8082268752
FaxNumber:  
Practice Location
Address1: 6600 KALANIANAOLE HWY
Address2: ISLAND URGENT CARE
City: HONOLULU
State: HI
PostalCode: 968251273
CountryCode: US
TelephoneNumber: 8087350007
FaxNumber: 8084331558
Other Information
ProviderEnumerationDate: 03/14/2006
LastUpdateDate: 07/23/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X296HIN Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363LF0000X296HIY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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