Healthcare Provider Details

I. General information

NPI: 1659491272
Provider Name (Legal Business Name): ERYLE T OKAMURA OD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98-1247 KAAHUMANU ST STE 116
AIEA HI
96701-5300
US

IV. Provider business mailing address

98-1247 KAAHUMANU ST STE 116
AIEA HI
96701-5300
US

V. Phone/Fax

Practice location:
  • Phone: 808-484-1133
  • Fax:
Mailing address:
  • Phone: 808-484-1133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number223
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: