Provider Demographics
NPI:1831318872
Name:CHRIS K. YAMAMOTO OD
Entity Type:Organization
Organization Name:CHRIS K. YAMAMOTO OD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:KEIJI
Authorized Official - Last Name:YAMAMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:OD,
Authorized Official - Phone:808-848-0527
Mailing Address - Street 1:2024 N KING ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-3470
Mailing Address - Country:US
Mailing Address - Phone:808-848-0527
Mailing Address - Fax:808-848-0528
Practice Address - Street 1:2024 N KING ST
Practice Address - Street 2:SUITE 105
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-3470
Practice Address - Country:US
Practice Address - Phone:808-848-0527
Practice Address - Fax:808-848-0528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI150152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIHCYODMedicare PIN
0414520001Medicare NSC