Provider Demographics
NPI:1396134508
Name:KAREN C. YAMAGUCHI, DPM, LLC
Entity type:Organization
Organization Name:KAREN C. YAMAGUCHI, DPM, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:C
Authorized Official - Last Name:YAMAGUCHI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:956-337-9512
Mailing Address - Street 1:1557 ALA LANI ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-1444
Mailing Address - Country:US
Mailing Address - Phone:956-337-9512
Mailing Address - Fax:
Practice Address - Street 1:615 PIIKOI ST STE 1401
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3189
Practice Address - Country:US
Practice Address - Phone:808-591-0020
Practice Address - Fax:808-591-0080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-13
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPO123213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty