Healthcare Provider Details

I. General information

NPI: 1114837143
Provider Name (Legal Business Name): LAURYN SAMESHIMA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4589 KAPOLEI PKWY
KAPOLEI HI
96707-1879
US

IV. Provider business mailing address

4589 KAPOLEI PKWY
KAPOLEI HI
96707-1879
US

V. Phone/Fax

Practice location:
  • Phone: 808-674-3919
  • Fax: 808-674-3914
Mailing address:
  • Phone: 808-674-3919
  • Fax: 808-674-3914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1075
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: