MEDICARE: VIVIAN LIN KYONO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QS0010X	Sports Medicine (Family Medicine) Physician	MD-20366	HI
2	207Q00000X	Family Medicine Physician	MD-20366	HI

General Provider Information

NPI Number	:	1427406321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIVIAN LIN KYONO MD

Provider Business Mailing Address
First Line	:	3-3295 KUHIO HWY
Second Line	:
City	:	LIHUE
State	:	HI
Zip	:	96766-1040
Country	:	US
Telephone Number	:	808-245-8874
Fax Number	:	808-246-9080

Provider Business Practice Location Address
First Line	:	3-3295 KUHIO HWY
Second Line	:
City	:	LIHUE
State	:	HI
Zip	:	96766-1040
Country	:	US
Telephone Number	:	808-627-3255
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2016
Last Update Date	:	09/22/2021

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Directions to “ VIVIAN LIN KYONO MD” Practice Location

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