Healthcare Provider Details

I. General information

NPI: 1922191725
Provider Name (Legal Business Name): GREGORY K. YIM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1319 PUNAHOU ST SUITE 1000
HONOLULU HI
96826-1001
US

IV. Provider business mailing address

1319 PUNAHOU ST SUITE 1000
HONOLULU HI
96826-1001
US

V. Phone/Fax

Practice location:
  • Phone: 808-946-4474
  • Fax: 808-976-4475
Mailing address:
  • Phone: 808-946-4474
  • Fax: 808-976-4475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD-6927
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD-6927
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: