Provider Demographics
NPI:1043256530
Name:YANO, STEPHEN SHIGEO (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:SHIGEO
Last Name:YANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99-128 AIEA HEIGHTS DR
Mailing Address - Street 2:#211
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-3925
Mailing Address - Country:US
Mailing Address - Phone:808-488-8441
Mailing Address - Fax:808-487-2003
Practice Address - Street 1:99-128 AIEA HEIGHTS DR
Practice Address - Street 2:#211
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-3925
Practice Address - Country:US
Practice Address - Phone:808-488-8441
Practice Address - Fax:808-487-2003
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HI4377208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00909601Medicaid