Basic Information
| Provider Information | |||||||||
| NPI: | 1346870417 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OSHIRO | ||||||||
| FirstName: | CHERNELL | ||||||||
| MiddleName: | AIKO LEILANI | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RBT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 377 | ||||||||
| Address2: | |||||||||
| City: | HANAPEPE | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967160377 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8086510865 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3083 AKAHI ST STE 101 | ||||||||
| Address2: | |||||||||
| City: | LIHUE | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967661102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8082455841 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2020 | ||||||||
| LastUpdateDate: | 01/17/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 01/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | RBT-19-106315 | HI | Y |
No ID Information.