MEDICARE: DR. JESSICA C IIDA OD

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
1	152W00000X	Optometrist	OD-840	HI

General Provider Information

NPI Number	:	1922450915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSICA C IIDA OD

Provider Business Mailing Address
First Line	:	1109 12TH AVE STE 103
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96816-3714
Country	:	US
Telephone Number	:	808-734-1988
Fax Number	:	808-735-6302

Provider Business Practice Location Address
First Line	:	1109 12TH AVE STE 103
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96816-3714
Country	:	US
Telephone Number	:	808-734-1988
Fax Number	:	808-735-6302

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2016
Last Update Date	:	01/17/2025

Similar Medicare Providers

1689776130 — DR. DONNA-LYNN L.S. CHING D.C.
Practice Location Address:

1109 12TH AVE STE 201
HONOLULU, HI
96816-3714

Practice Phone: 808-732-2662
Practice Fax:

1942389879 — DR. GERALD N. MATSUYAMA O.D.
Practice Location Address:

1109 12TH AVE , #103
HONOLULU, HI
96816-3714

Practice Phone: 808-734-1988
Practice Fax:

1154443166 — GERALD N. MATSUYAMA, O.D., LLC
Practice Location Address:

1109 12TH AVE STE 103
HONOLULU, HI
96816-3714

Practice Phone: 808-734-1988
Practice Fax:

1801070388 — MS. ELIZA MARTIN L.AC.
Practice Location Address:

1109 12TH AVE
HONOLULU, HI
96816-3714

Practice Phone: 808-782-5061
Practice Fax: 808-734-8904

1255706081 — SHERRI ANN K. KAAHANUI PSYD, CSAC
Practice Location Address:

1109 12TH AVE STE 201
HONOLULU, HI
96816-3714

Practice Phone: 808-927-8746
Practice Fax:

1205355807 — SUZANNE I. PARK LCSW
Practice Location Address:

1109 12TH AVE STE 201
HONOLULU, HI
96816-3714

Practice Phone: 831-350-0109
Practice Fax:

Directions to “ DR. JESSICA C IIDA OD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.