Provider Demographics
NPI:1821298910
Name:ROBERT P. YOUNG M.D., INC
Entity Type:Organization
Organization Name:ROBERT P. YOUNG M.D., INC
Other - Org Name:THE EYE CENTER OF HAWAII
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:PRESTON
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-329-2010
Mailing Address - Street 1:75-167 HUALALAI RD
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-1714
Mailing Address - Country:US
Mailing Address - Phone:808-329-2010
Mailing Address - Fax:
Practice Address - Street 1:75-167 HUALALAI RD
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-1714
Practice Address - Country:US
Practice Address - Phone:808-329-2010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-18
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2884261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI03642002Medicaid
HI03642001Medicaid
HID43534Medicare UPIN
HI03642002Medicaid