Provider Demographics
NPI:1912145574
Name:YONEMOTO, LAURIE ALICE (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:ALICE
Last Name:YONEMOTO
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 1:140 HOLMES AVE
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:06820
Mailing Address - Country:US
Mailing Address - Phone:808-295-4080
Mailing Address - Fax:
Practice Address - Street 1:140 HOLMES AVE
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-3818
Practice Address - Country:US
Practice Address - Phone:808-295-4080
Practice Address - Fax:808-295-4080
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-04
Last Update Date:2013-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT049611207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology