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NPI Code Detail

MEDICARE: CHRISTINE CHIYEKO ISHIKAWA O.D.

MEDICARE: CHRISTINE CHIYEKO ISHIKAWA O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist624HI

General Provider Information

NPI Number : 1689822793
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE CHIYEKO ISHIKAWA O.D.
Provider Business Mailing Address
First Line : 333 KEAHOLE ST BLDG A
Second Line :
City : HONOLULU
State : HI
Zip : 96825-3428
Country : US
Telephone Number : 808-395-6578
Fax Number :
Provider Business Practice Location Address
First Line : 333 KEAHOLE ST BLDG A
Second Line :
City : HONOLULU
State : HI
Zip : 96825-3428
Country : US
Telephone Number : 808-395-6578
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2008
Last Update Date : 04/07/2010

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