Provider Demographics
NPI:1003099946
Name:LYMAN N. YOSHIMURA O.D., INC.
Entity Type:Organization
Organization Name:LYMAN N. YOSHIMURA O.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:O.D./PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LYMAN
Authorized Official - Middle Name:N
Authorized Official - Last Name:YOSHIMURA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:808-245-2772
Mailing Address - Street 1:2964 EWALU ST
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-1377
Mailing Address - Country:US
Mailing Address - Phone:808-245-2772
Mailing Address - Fax:808-245-4541
Practice Address - Street 1:2964 EWALU ST
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1377
Practice Address - Country:US
Practice Address - Phone:808-245-2772
Practice Address - Fax:808-245-4541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-13
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOD 92332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000058610OtherHMSA
HI051248-01Medicaid
HIY41323Medicare UPIN
HIH0000PGBBKMedicare PIN
HI0000058610OtherHMSA