Basic Information
| Provider Information | |||||||||
| NPI: | 1083666978 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZHANG | ||||||||
| FirstName: | YI | ||||||||
| MiddleName: | JONATHAN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1301 PUNCHBOWL ST | ||||||||
| Address2: | |||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968132499 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8086911000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1301 PUNCHBOWL ST | ||||||||
| Address2: | |||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968132499 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8086911000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2006 | ||||||||
| LastUpdateDate: | 11/01/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | 047873 | GA | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | M6970 | TX | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 2085N0700X | 047873 | GA | N | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology | 2085N0700X | M6970 | TX | N | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology | 207T00000X | MD-22831 | HI | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
ID Information
| ID | Type | State | Issuer | Description | P00442043 | 01 | TX | RAILROAD MEDICARE | OTHER | 188567502 | 05 | TX | MEDICAID | 188567503 | 05 | TX | MEDICAID | 8EB171 | 01 | TX | BLUE CROSS BLUE SHIELD | OTHER | P01331458 | 01 | TX | RR MEDICARE | OTHER | 003645 | 05 | HI | MEDICAID | 8R9789 | 01 | TX | BLUE CROSS BLUE SHIELD | OTHER | 188567501 | 05 | TX | MEDICAID |