Provider Demographics
NPI:1174134167
Name:CHRISTINE SHOKORIAN LLC
Entity type:Organization
Organization Name:CHRISTINE SHOKORIAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOKORIAN
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:808-344-2211
Mailing Address - Street 1:1450 S KIHEI RD APT D108
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-8164
Mailing Address - Country:US
Mailing Address - Phone:808-344-2211
Mailing Address - Fax:
Practice Address - Street 1:1450 S KIHEI RD APT D108
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-8164
Practice Address - Country:US
Practice Address - Phone:808-344-2211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-12
Last Update Date:2020-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty