Provider Demographics
NPI:1083666978
Name:ZHANG, YI JONATHAN (MD)
Entity Type:Individual
Prefix:
First Name:YI
Middle Name:JONATHAN
Last Name:ZHANG
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 1:1301 PUNCHBOWL ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2499
Mailing Address - Country:US
Mailing Address - Phone:808-691-1000
Mailing Address - Fax:
Practice Address - Street 1:1301 PUNCHBOWL ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2499
Practice Address - Country:US
Practice Address - Phone:808-691-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA047873207T00000X, 2085N0700X
TXM6970207T00000X, 2085N0700X
HIMD-22831207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00442043OtherRAILROAD MEDICARE
TX188567502Medicaid
TX188567503Medicaid
TX8EB171OtherBLUE CROSS BLUE SHIELD
TXP01331458OtherRR MEDICARE
HI003645Medicaid
TX8R9789OtherBLUE CROSS BLUE SHIELD
TX188567501Medicaid
TX188567502Medicaid
TX188567503Medicaid
TX188567501Medicaid