Healthcare Provider Details

I. General information

NPI: 1861199366
Provider Name (Legal Business Name): KAUAI OPTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2023
Last Update Date: 06/23/2023
Certification Date: 06/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4-831 KUHIO HWY STE 434
KAPAA HI
96746-1574
US

IV. Provider business mailing address

4-831 KUHIO HWY STE 434
KAPAA HI
96746-1574
US

V. Phone/Fax

Practice location:
  • Phone: 808-822-3733
  • Fax:
Mailing address:
  • Phone: 808-822-3733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. NICHOLAS KLAUBA
Title or Position: OPTOMETRIST
Credential:
Phone: 808-822-3733