Provider Demographics
NPI:1639359813
Name:YAMAZAKI, MICHAEL KENJI (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:KENJI
Last Name:YAMAZAKI
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 1:888 S KING ST
Mailing Address - Street 2:BONE AND JOINT CENTER
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3097
Mailing Address - Country:US
Mailing Address - Phone:808-522-2639
Mailing Address - Fax:808-522-4401
Practice Address - Street 1:888 S KING ST
Practice Address - Street 2:BONE AND JOINT CENTER
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3097
Practice Address - Country:US
Practice Address - Phone:808-522-2639
Practice Address - Fax:808-522-4401
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA101393208100000X
HI15519208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation