Provider Demographics
NPI:1699935718
Name:ERNIE YIM, M.D. INC.
Entity type:Organization
Organization Name:ERNIE YIM, M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:YIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-533-1372
Mailing Address - Street 1:2228 LILIHA ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-1650
Mailing Address - Country:US
Mailing Address - Phone:808-533-1372
Mailing Address - Fax:808-595-8309
Practice Address - Street 1:2228 LILIHA ST
Practice Address - Street 2:SUITE 202
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-1650
Practice Address - Country:US
Practice Address - Phone:808-533-1372
Practice Address - Fax:808-595-8309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD 03585173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIBDHBNMedicare UPIN