Healthcare Provider Details

I. General information

NPI: 1790864197
Provider Name (Legal Business Name): MIKI, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2006
Last Update Date: 07/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 ALA MOANA BLVD STE 1247
HONOLULU HI
96814-4611
US

IV. Provider business mailing address

1450 ALA MOANA BLVD STE 1247
HONOLULU HI
96814-4611
US

V. Phone/Fax

Practice location:
  • Phone: 808-943-6454
  • Fax: 808-943-2736
Mailing address:
  • Phone: 808-943-6454
  • Fax: 808-943-2736

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number263
License Number StateHI

VIII. Authorized Official

Name: MR. HIDEKI YAMANE
Title or Position: VICE-PRESIDENT
Credential:
Phone: 808-943-6454