Provider Demographics
NPI:1417167438
Name:HLA, MYA MOE (MD)
Entity Type:Individual
Prefix:DR
First Name:MYA
Middle Name:MOE
Last Name:HLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HLA
Other - Middle Name:MYA
Other - Last Name:MOE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:625 AUWINA ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-3428
Mailing Address - Country:US
Mailing Address - Phone:808-263-0180
Mailing Address - Fax:808-843-8382
Practice Address - Street 1:2239 N SCHOOL ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-2539
Practice Address - Country:US
Practice Address - Phone:808-791-9400
Practice Address - Fax:808-791-9456
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD 149662084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry