Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 123 | HI |
N | 213ES0131X | Foot Surgery | 1528 | TX |
NPI | 1215973029 |
---|---|
Provider Name | Karen C. Yamaguchi |
First Address | Honolulu, HI 96814-3116 |
Second Address | Honolulu, HI 96814-3116 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 17/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0082FA | BC BS PROVIDER NUMBER (01) | TX |
140993002 | (05) | TX |
U83446 | (02) | TX |