Provider Demographics
NPI:1699759746
Name:LI, GAYLYN G (MD)
Entity type:Individual
Prefix:DR
First Name:GAYLYN
Middle Name:G
Last Name:LI
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1319 PUNAHOU ST
Mailing Address - Street 2:824
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-1001
Mailing Address - Country:US
Mailing Address - Phone:808-203-6530
Mailing Address - Fax:808-951-1637
Practice Address - Street 1:1319 PUNAHOU ST
Practice Address - Street 2:801
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1001
Practice Address - Country:US
Practice Address - Phone:808-203-6580
Practice Address - Fax:808-951-1637
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2015-11-09
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Provider Licenses
StateLicense IDTaxonomies
HIMD4218207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI008744Medicaid
100030Medicare ID - Type Unspecified
HI008744Medicaid