Basic Information
Provider Information
NPI: 1720176373
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YOUNG
FirstName: LYNETTE
MiddleName: L.
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: NAKAGAWA
OtherFirstName: LYNETTE
OtherMiddleName: YOUNG
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: M.D.
OtherLastNameType: 5
Mailing Information
Address1: 1946 YOUNG ST
Address2: SUITE 360
City: HONOLULU
State: HI
PostalCode: 968262150
CountryCode: US
TelephoneNumber: 8089737320
FaxNumber: 8089737325
Practice Location
Address1: 1319 PUNAHOU ST
Address2: SUITE 751
City: HONOLULU
State: HI
PostalCode: 968261001
CountryCode: US
TelephoneNumber: 8089838387
FaxNumber: 8089451570
Other Information
ProviderEnumerationDate: 10/10/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0204XMD-7512HIY Allopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine

No ID Information.


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