Healthcare Provider Details

I. General information

NPI: 1043238710
Provider Name (Legal Business Name): HERBERT K M YEE PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 11/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 S KING ST STE 1455
HONOLULU HI
96814-1948
US

IV. Provider business mailing address

PO BOX 547
KAILUA HI
96734-0547
US

V. Phone/Fax

Practice location:
  • Phone: 808-348-3763
  • Fax: 808-597-1119
Mailing address:
  • Phone: 808-348-3763
  • Fax: 808-597-1119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number400
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT400
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: