Provider Demographics
NPI: | 1952043291 |
---|---|
Name: | STEPHEN S. YANO, M.D., INC. |
Entity Type: | Organization |
Organization Name: | STEPHEN S. YANO, M.D., INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | NURSE MANAGER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | RAE ANN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | CHOCK-SAIKI |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 808-488-8441 |
Mailing Address - Street 1: | 99-128 AIEA HEIGHTS DR STE 211 |
Mailing Address - Street 2: | |
Mailing Address - City: | AIEA |
Mailing Address - State: | HI |
Mailing Address - Zip Code: | 96701-3972 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 808-488-8441 |
Mailing Address - Fax: | 808-200-3790 |
Practice Address - Street 1: | 99-128 AIEA HEIGHTS DR STE 211 |
Practice Address - Street 2: | |
Practice Address - City: | AIEA |
Practice Address - State: | HI |
Practice Address - Zip Code: | 96701-3972 |
Practice Address - Country: | US |
Practice Address - Phone: | 808-488-8441 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2022-04-07 |
Last Update Date: | 2022-04-07 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
HI | 1043256530 | Medicaid |