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General NPI Number Information
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NPI Number | 1336203363
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Entity Type | Individual
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Provider Name | YASHODA BHASKAR M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 02/04/2020
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Provider Practice Location Address
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Address Line | 65-1241 POMAIKAI PL STE 6
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City | KAMUELA
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State | HI
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Zip | 96743-7311
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Country | US
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Telephone | 808-757-9292
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Fax |
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Provider Business Mailing Address
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Address Line | 73-1225 KAUILANIAKEA DR
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City | KAILUA KONA
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State | HI
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Zip | 96740-7600
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Country | US
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Telephone | 808-989-6318
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 19585
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License Number State | HI
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