Healthcare Provider Details

I. General information

NPI: 1265486518
Provider Name (Legal Business Name): MICHAEL YOICHI KOMEYA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 10/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 HALEKAUWILA ST SUITE 307
HONOLULU HI
96813-5035
US

IV. Provider business mailing address

550 HALEKAUWILA ST SUITE 307
HONOLULU HI
96813-5035
US

V. Phone/Fax

Practice location:
  • Phone: 808-545-5902
  • Fax: 808-545-5932
Mailing address:
  • Phone: 808-545-5902
  • Fax: 808-545-5932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberMD8656
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: