Provider Demographics
NPI:1174634067
Name:SIM, JAMES Y (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:Y
Last Name:SIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1319 PUNAHOU ST STE 1160
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-1089
Mailing Address - Country:US
Mailing Address - Phone:808-942-7707
Mailing Address - Fax:808-955-3301
Practice Address - Street 1:1319 PUNAHOU ST STE 1160
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1089
Practice Address - Country:US
Practice Address - Phone:808-942-7707
Practice Address - Fax:808-955-3301
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI124452080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI53641901Medicaid
HIH89969Medicare UPIN
HI55676Medicare ID - Type Unspecified