Basic Information
| Provider Information | |||||||||
| NPI: | 1801144993 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YI | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 86-120 FARRINGTON HWY STE C301 | ||||||||
| Address2: | |||||||||
| City: | WAIANAE | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967923072 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8086967021 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 86-120 FARRINGTON HWY STE C301 | ||||||||
| Address2: | |||||||||
| City: | WAIANAE | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967923072 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8086967021 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2012 | ||||||||
| LastUpdateDate: | 03/01/2019 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | 02/13/2019 | ||||||||
| NPIReactivationDate: | 02/27/2019 | ||||||||
| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 895 | HI | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.