Provider Demographics
NPI:1992016802
Name:INOUYE, JILL MYNW (MD)
Entity type:Individual
Prefix:DR
First Name:JILL
Middle Name:MYNW
Last Name:INOUYE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98-1079 MOANALUA RD STE 300
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4722
Mailing Address - Country:US
Mailing Address - Phone:808-485-4120
Mailing Address - Fax:808-485-3090
Practice Address - Street 1:98-1079 MOANALUA RD STE 300
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4722
Practice Address - Country:US
Practice Address - Phone:808-485-4120
Practice Address - Fax:808-485-3090
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-17030207QS0010X
NM390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine