Individual
DR. KIYOTAKA ALBERT YAZAWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1027 HALA DR, MALUHIA, HONOLULU, HI 96817
(808) 832-6129
(808) 832-1932
Mailing address
1508B PUALELE PL, HONOLULU, HI 96816-3326
(808) 737-8212
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
MD-11070
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00067495
—
HI
01
—
00B0228664
BLUE CROSS/ BLUE SHIELD
HI
Enumeration date
01/23/2006
Last updated
01/24/2013
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