Healthcare Provider Details

I. General information

NPI: 1982887279
Provider Name (Legal Business Name): DR FREDRICK L YOST, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2007
Last Update Date: 08/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 LUSITANA ST STE 614
HONOLULU HI
96813-2442
US

IV. Provider business mailing address

1508 LEHIA ST
HONOLULU HI
96818-1829
US

V. Phone/Fax

Practice location:
  • Phone: 808-535-9678
  • Fax: 808-423-1109
Mailing address:
  • Phone: 808-421-9678
  • Fax: 808-423-1109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD-8791
License Number StateHI

VIII. Authorized Official

Name: FREDRICK L YOST
Title or Position: PRESIDENT
Credential: M.D.
Phone: 808-421-9678