Healthcare Provider Details
I. General information
NPI: 1295789865
Provider Name (Legal Business Name): OHANA EYE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/19/2006
Last Update Date: 02/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1401 S BERETANIA ST SUITE 900
HONOLULU HI
96814-1870
US
IV. Provider business mailing address
1401 S BERETANIA ST SUITE 900
HONOLULU HI
96814-1870
US
V. Phone/Fax
- Phone: 808-942-5800
- Fax: 808-949-4553
- Phone: 808-942-5800
- Fax: 808-949-4553
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | MD9013 |
| License Number State | HI |
VIII. Authorized Official
Name: DR.
DOUGLAS
FREEMA
CHU
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 808-942-5800