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General NPI Number Information
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NPI Number | 1427791839
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Entity Type | Organization
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Legal Business Name | KEITH YAMAMOTO
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Dates
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Enumeration Date | 04/14/2022
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Last Update Date | 04/14/2022
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Provider Practice Location Address
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Address Line | 1050 S KING ST # 609
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City | HONOLULU
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State | HI
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Zip | 96814-2114
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Country | US
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Telephone | 808-591-8540
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Fax | 808-591-8541
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Provider Business Mailing Address
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Address Line | 1050 S KING ST # 609
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City | HONOLULU
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State | HI
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Zip | 96814-2114
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Country | US
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Telephone | 808-591-8540
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Fax | 808-591-8541
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Authorized Official
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Title or Position | OWNER
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Name | MR. KEITH YAMAMOTO
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Credential | DISPENSING OPTICIAN
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Telephone | 808-591-8540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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