Healthcare Provider Details

I. General information

NPI: 1790785269
Provider Name (Legal Business Name): AKIKO M YAZAWA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/27/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1319 PUNAHOU ST # 1180
HONOLULU HI
96826-1001
US

IV. Provider business mailing address

1319 PUNAHOU ST # 1180
HONOLULU HI
96826-1001
US

V. Phone/Fax

Practice location:
  • Phone: 808-955-6324
  • Fax: 808-955-5741
Mailing address:
  • Phone: 808-955-6324
  • Fax: 808-955-5741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD9857
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: