Provider Demographics
NPI:1669504635
Name:YANG, HENRY HANALEI (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:HANALEI
Last Name:YANG
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 1:101 AUPUNI ST
Mailing Address - Street 2:SUITE 242
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-4246
Mailing Address - Country:US
Mailing Address - Phone:808-961-6069
Mailing Address - Fax:808-969-1998
Practice Address - Street 1:101 AUPUNI ST
Practice Address - Street 2:SUITE 242
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4246
Practice Address - Country:US
Practice Address - Phone:808-961-6069
Practice Address - Fax:808-969-1998
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI66542084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI052975-01Medicaid
HIB6062-0OtherHMSA
HI052975-01Medicaid
HI0000BDVTGMedicare ID - Type Unspecified