Healthcare Provider Details

I. General information

NPI: 1487601449
Provider Name (Legal Business Name): LORI L YAMANAKA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1319 PUNAHOU ST SUITE 1050
HONOLULU HI
96826-1001
US

IV. Provider business mailing address

1319 PUNAHOU ST SUITE 1050
HONOLULU HI
96826-1001
US

V. Phone/Fax

Practice location:
  • Phone: 808-942-8144
  • Fax: 808-955-3827
Mailing address:
  • Phone: 808-942-8144
  • Fax: 808-955-3827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD 10566
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: