Healthcare Provider Details

I. General information

NPI: 1568309839
Provider Name (Legal Business Name): IVANA YOON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1356 LUSITANA ST FL 7
HONOLULU HI
96813-2409
US

IV. Provider business mailing address

1356 LUSITANA ST FL 7
HONOLULU HI
96813-2409
US

V. Phone/Fax

Practice location:
  • Phone: 808-990-3931
  • Fax:
Mailing address:
  • Phone: 808-990-3931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMDR-9258
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: