Provider Demographics
NPI:1194948273
Name:YOSHIMOTO PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:YOSHIMOTO PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:MAKOA
Authorized Official - Last Name:YOSHIMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:808-525-5300
Mailing Address - Street 1:600 KAPIOLANI BLVD
Mailing Address - Street 2:#208
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813
Mailing Address - Country:US
Mailing Address - Phone:808-525-5300
Mailing Address - Fax:808-525-5301
Practice Address - Street 1:600 KAPIOLANI BLVD
Practice Address - Street 2:#208
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813
Practice Address - Country:US
Practice Address - Phone:808-525-5300
Practice Address - Fax:808-525-5301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI07928702Medicaid
H45695Medicare ID - Type Unspecified