Healthcare Provider Details

I. General information

NPI: 1467146944
Provider Name (Legal Business Name): ERIN CORINNE YAMAMOTO OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN CORINNE GEYER

II. Dates (important events)

Enumeration Date: 06/07/2023
Last Update Date: 06/07/2023
Certification Date: 06/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

392 KAPIOLANI ST
HILO HI
96720-7309
US

IV. Provider business mailing address

PO BOX 607
PAPAIKOU HI
96781-0607
US

V. Phone/Fax

Practice location:
  • Phone: 214-415-9204
  • Fax:
Mailing address:
  • Phone: 214-415-9204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0000000
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: