1427271055 NPI number — MRS. AUDREY MITSUKO YONESHIGE P.T.

Table of content: MRS. AUDREY MITSUKO YONESHIGE P.T. (NPI 1427271055)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427271055 NPI number — MRS. AUDREY MITSUKO YONESHIGE P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YONESHIGE
Provider First Name:
AUDREY
Provider Middle Name:
MITSUKO
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
P.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SHIMOKAWA
Provider Other First Name:
AUDREY
Provider Other Middle Name:
MITSUKO
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
PT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1427271055
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/26/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4540 ALIIKOA STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96821
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-623-4840
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1907 SOUTH BERETANIA ST
Provider Second Line Business Practice Location Address:
ARTESIAN PLAZA FIRST FLOOR KAPIOLANI WOMENS CENTER
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96826
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-973-6540
Provider Business Practice Location Address Fax Number:
808-973-6537
Provider Enumeration Date:
04/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  365 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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