Provider Demographics
NPI:1255437232
Name:HORI, YASUSHI JOHN (MD)
Entity type:Individual
Prefix:
First Name:YASUSHI
Middle Name:JOHN
Last Name:HORI
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 1:2155 KALAKAUA AVE
Mailing Address - Street 2:SUITE 308
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-2351
Mailing Address - Country:US
Mailing Address - Phone:808-924-3399
Mailing Address - Fax:808-923-7606
Practice Address - Street 1:2155 KALAKAUA AVE
Practice Address - Street 2:SUITE 308
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-2351
Practice Address - Country:US
Practice Address - Phone:808-924-3399
Practice Address - Fax:808-923-7606
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-10758207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI52025Medicare ID - Type Unspecified
HIH02622Medicare UPIN