Healthcare Provider Details

I. General information

NPI: 1154751535
Provider Name (Legal Business Name): IRENE S.K. YAMAMOTO, M.D. INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2013
Last Update Date: 11/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1481 S. KING STREET STE 343
HONOLULU HI
96814
US

IV. Provider business mailing address

1221 KAPIOLANI BLVD STE 820
HONOLULU HI
96814-3515
US

V. Phone/Fax

Practice location:
  • Phone: 808-943-9400
  • Fax: 808-942-2181
Mailing address:
  • Phone: 808-524-5247
  • Fax: 808-440-5251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD8436
License Number StateHI

VIII. Authorized Official

Name: DAVID GRIFFITH
Title or Position: ADMINISTRATOR
Credential:
Phone: 808-440-5256