Healthcare Provider Details

I. General information

NPI: 1487945929
Provider Name (Legal Business Name): RODNEY K YAMAKI MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2011
Last Update Date: 05/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99-080 KAUHALE ST SUITE C22
AIEA HI
96701-4116
US

IV. Provider business mailing address

PO BOX 37862
HONOLULU HI
96837-0862
US

V. Phone/Fax

Practice location:
  • Phone: 808-777-0689
  • Fax: 866-592-3149
Mailing address:
  • Phone: 808-664-1104
  • Fax: 866-592-3149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD14814
License Number StateHI

VIII. Authorized Official

Name: RODNEY K YAMAKI
Title or Position: PROVIDER
Credential: MD
Phone: 808-664-1104