Healthcare Provider Details

I. General information

NPI: 1578673661
Provider Name (Legal Business Name): LYNETTE MIYOSHI FURUKAWA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 10/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 N KUAKINI ST 613
HONOLULU HI
96817-2364
US

IV. Provider business mailing address

321 N KUAKINI ST 613
HONOLULU HI
96817-2364
US

V. Phone/Fax

Practice location:
  • Phone: 808-521-2672
  • Fax: 808-521-2673
Mailing address:
  • Phone: 808-521-2672
  • Fax: 808-521-2673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number4012
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: