Healthcare Provider Details

I. General information

NPI: 1336181478
Provider Name (Legal Business Name): MELODEE MUI-YING YOUNG D.P.T
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

863 HALEKAUWILA ST
HONOLULU HI
96813-5317
US

IV. Provider business mailing address

PO BOX 11973
HONOLULU HI
96828-0973
US

V. Phone/Fax

Practice location:
  • Phone: 808-597-1555
  • Fax: 808-597-1596
Mailing address:
  • Phone: 808-597-1555
  • Fax: 808-597-1596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT1926
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: