Provider Demographics
NPI:1811907074
Name:YONG, CLARA PH (MD)
Entity type:Individual
Prefix:DR
First Name:CLARA
Middle Name:PH
Last Name:YONG
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 1:30 AULIKE ST STE 405
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2751
Mailing Address - Country:US
Mailing Address - Phone:808-263-7411
Mailing Address - Fax:808-263-7455
Practice Address - Street 1:30 AULIKE ST STE 405
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2751
Practice Address - Country:US
Practice Address - Phone:808-263-7411
Practice Address - Fax:808-263-7455
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2008-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI8072207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00C0052666OtherHMSA
HIP00140629OtherMEDICARE RAILROAD
HI04633103Medicaid
HI00C0052666OtherHMSA
HIP00140629OtherMEDICARE RAILROAD