Healthcare Provider Details

I. General information

NPI: 1740252337
Provider Name (Legal Business Name): FUKAI AND ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 05/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1371 HECLA DR STE C
LOUISVILLE CO
80027-2318
US

IV. Provider business mailing address

1371 HECLA DR STE C
LOUISVILLE CO
80027-2318
US

V. Phone/Fax

Practice location:
  • Phone: 303-666-7226
  • Fax: 303-665-3367
Mailing address:
  • Phone: 303-666-7226
  • Fax: 303-665-3367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL EDWIN FUKAI
Title or Position: OPTOMETRIST
Credential: OD
Phone: 303-666-7226