| Cory T Miyamoto Md Inc | |
|
321 N Kuakini St Ste 714 Honolulu HI 96817-2362 | |
| (808) 741-3037 | |
| (808) 538-7850 |
| Full Name | Cory T Miyamoto Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 321 N Kuakini St Ste 714, Honolulu, Hawaii |
| Authorized Official Name and Position | Kit Garcia (OFFICE MANAGER) |
| Authorized Official Contact | 8087413037 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cory T Miyamoto Md Inc 321 N Kuakini St Ste 714 Honolulu HI 96817-2362 Ph: (808) 741-3037 | Cory T Miyamoto Md Inc 321 N Kuakini St Ste 714 Honolulu HI 96817-2362 Ph: (808) 741-3037 |
| NPI Number | 1538642954 |
|---|---|
| Provider Enumeration Date | 09/11/2018 |
| Last Update Date | 09/11/2018 |
| Medicare PECOS PAC ID | 6002155736 |
|---|---|
| Medicare Enrollment ID | O20190225001705 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538642954 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Cory T Miyamoto |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1063451003 PECOS PAC ID: 7012941636 Enrollment ID: I20050922001270 |
| Provider Name | Lisa A Kelleher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932470481 PECOS PAC ID: 1850546854 Enrollment ID: I20130222000524 |
| Provider Name | Donita K Valdez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669964474 PECOS PAC ID: 9537594502 Enrollment ID: I20200122001071 |
| Provider Name | Yuka Usui Webb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982142097 PECOS PAC ID: 0648671222 Enrollment ID: I20210702002018 |
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