Provider Demographics
NPI:1982795308
Name:YAMAUCHI, DALE KAZUO (DC)
Entity Type:Individual
Prefix:DR
First Name:DALE
Middle Name:KAZUO
Last Name:YAMAUCHI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 KAPIOLANI BLVD
Mailing Address - Street 2:SUITE 525
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-3512
Mailing Address - Country:US
Mailing Address - Phone:808-593-9941
Mailing Address - Fax:808-593-9941
Practice Address - Street 1:1221 KAPIOLANI BLVD
Practice Address - Street 2:SUITE 525
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3512
Practice Address - Country:US
Practice Address - Phone:808-593-9941
Practice Address - Fax:808-593-9941
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDC290111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI098426OtherHMSA
HIT41320Medicare UPIN
HIH0000QCBZVMedicare PIN