Healthcare Provider Details
I. General information
NPI: 1336169929
Provider Name (Legal Business Name): JAMES H SAKAMOTO OD INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/19/2006
Last Update Date: 01/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
610 KILANI AVE
WAHIAWA HI
96786-1904
US
IV. Provider business mailing address
610 KILANI AVE
WAHIAWA HI
96786-1904
US
V. Phone/Fax
- Phone: 808-622-2020
- Fax: 808-622-9009
- Phone: 808-622-2020
- Fax: 808-622-9009
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | 66, 336 |
| License Number State | HI |
VIII. Authorized Official
Name: DR.
JAMES
H.
SAKAMOTO
Title or Position: PRESIDENT
Credential: O.D.
Phone: 808-622-2020