Provider Demographics
NPI:1134321250
Name:TRIVEDI, YASH (MD)
Entity Type:Individual
Prefix:
First Name:YASH
Middle Name:
Last Name:TRIVEDI
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 1:45-319 PUULOKO PL
Mailing Address - Street 2:DEPRTMENT OF MEDICINE
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-2788
Mailing Address - Country:US
Mailing Address - Phone:337-540-5500
Mailing Address - Fax:
Practice Address - Street 1:45-319 PUULOKO PL
Practice Address - Street 2:DEPRTMENT OF MEDICINE
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-2788
Practice Address - Country:US
Practice Address - Phone:337-540-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD202144207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA09292Medicaid