Individual
TRACEY YAMAMOTO-KUBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
915 N KING ST, HONOLULU, HI 96817-4544
(808) 845-0686
(808) 845-0798
Mailing address
915 N KING ST, HONOLULU, HI 96817-4544
(808) 845-0686
(808) 845-0798
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD-376
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000213074
BLUE CROSS BLUE SHIELD
HI
05
—
0051863109
—
HI
Enumeration date
08/20/2006
Last updated
07/08/2007
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