Healthcare Provider Details

I. General information

NPI: 1699935718
Provider Name (Legal Business Name): ERNIE YIM, M.D. INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2008
Last Update Date: 06/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2228 LILIHA ST SUITE 202
HONOLULU HI
96817-1650
US

IV. Provider business mailing address

2228 LILIHA ST SUITE 202
HONOLULU HI
96817-1650
US

V. Phone/Fax

Practice location:
  • Phone: 808-533-1372
  • Fax: 808-595-8309
Mailing address:
  • Phone: 808-533-1372
  • Fax: 808-595-8309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberMD 03585
License Number StateHI

VIII. Authorized Official

Name: DR. ERNIE M YIM
Title or Position: PRESIDENT
Credential: M.D.
Phone: 808-533-1372