Provider Demographics
NPI:1104991611
Name:YUEN, CARLTON K (MD)
Entity type:Individual
Prefix:DR
First Name:CARLTON
Middle Name:K
Last Name:YUEN
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 1:1029 KAPAHULU AVE
Mailing Address - Street 2:SUITE 502
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-1332
Mailing Address - Country:US
Mailing Address - Phone:808-782-1861
Mailing Address - Fax:808-218-7830
Practice Address - Street 1:1029 KAPAHULU AVE
Practice Address - Street 2:SUITE 502
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-1332
Practice Address - Country:US
Practice Address - Phone:808-782-1861
Practice Address - Fax:808-218-7830
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD13332207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000255224Medicaid
HIBE153Medicare PIN
HI0000255224Medicaid