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General NPI Number Information
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NPI Number | 1427303536
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Entity Type | Individual
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Provider Name | HAIDONG YANG O.D.
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Gender | Male
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Dates
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Enumeration Date | 07/16/2012
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Last Update Date | 12/14/2021
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Provider Practice Location Address
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Address Line | 1178 KINOOLE ST STE A
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City | HILO
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State | HI
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Zip | 96720-7206
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Country | US
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Telephone | 808-356-3820
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Fax |
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Provider Business Mailing Address
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Address Line | MSC 61329 PO BOX 1300
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City | HONOLULU
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State | HI
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Zip | 96807-1300
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Country | US
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Telephone | 808-356-3820
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Fax | 808-697-5488
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OD-757
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License Number State | HI
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