Provider Demographics
NPI:1821144627
Name:YAMASHIRO, ELAINE M (MD)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:M
Last Name:YAMASHIRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:792 N KALAHEO AVE APT C
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-1974
Mailing Address - Country:US
Mailing Address - Phone:808-522-0190
Mailing Address - Fax:808-523-9068
Practice Address - Street 1:321 N KUAKINI ST
Practice Address - Street 2:SUITE 405
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2364
Practice Address - Country:US
Practice Address - Phone:808-522-0190
Practice Address - Fax:808-523-9068
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD65272085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00E0223775OtherQUEST HMSA
HI08934105Medicaid
HI00D0223778OtherQUEST HMSA
HI08934104Medicaid
HIMD6527-04OtherMDX
HI00E0223775OtherQUEST HMSA
HIMD6527-04OtherMDX