Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 2101 | HI |
NPI | 1093733081 |
---|---|
Provider Name | Dr. Christopher Jay Masayuki Yamada |
First Address | Honolulu, HI 96815-4488 |
Second Address | Honolulu, HI 96815-4488 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 25/11/2014 |