Healthcare Provider Details

I. General information

NPI: 1154351005
Provider Name (Legal Business Name): WILLIAM J. YARBROUGH, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 12/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 LUSITANA STREET SUITE 602
HONOLULU HI
96813-2431
US

IV. Provider business mailing address

1329 LUSITANA STREET SUITE 602
HONOLULU HI
96813-2431
US

V. Phone/Fax

Practice location:
  • Phone: 808-522-5055
  • Fax: 808-524-6306
Mailing address:
  • Phone: 808-522-5055
  • Fax: 808-524-6306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: MARILYNN Y HATA
Title or Position: ADMINISTRATOR
Credential:
Phone: 808-522-5055