Healthcare Provider Details

I. General information

NPI: 1144528340
Provider Name (Legal Business Name): COMPASSIONATE EYE CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2011
Last Update Date: 09/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 PIIKOI STREET SUITE 1510
HONOLULU HI
96814
US

IV. Provider business mailing address

615 PIIKOI STREET SUITE 1510
HONOLULU HI
96814
US

V. Phone/Fax

Practice location:
  • Phone: 808-593-2377
  • Fax: 808-593-1447
Mailing address:
  • Phone: 808-593-2377
  • Fax: 808-593-1447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD-14396
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number14396
License Number StateHI

VIII. Authorized Official

Name: DR. CONSTANCE ANN COX-WONG
Title or Position: PRESIDENT, COMPASSIONATE EYE CARE I
Credential: M.D.
Phone: 808-893-2377