Provider Demographics
NPI:1487751285
Name:YEO, CHOON KIA (MD)
Entity type:Individual
Prefix:MR
First Name:CHOON
Middle Name:KIA
Last Name:YEO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 LILIHA ST
Mailing Address - Street 2:#101
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817
Mailing Address - Country:US
Mailing Address - Phone:808-538-1905
Mailing Address - Fax:808-538-0537
Practice Address - Street 1:1650 LILIHA ST
Practice Address - Street 2:#101
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817
Practice Address - Country:US
Practice Address - Phone:808-538-1905
Practice Address - Fax:808-538-0537
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2525207Q00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI03449501Medicaid
HIC38103OtherHMSA
C98987Medicare UPIN
HI03449501Medicaid